Correlation Of Preoperative Elderly Hip Fracture Plasma Fibrinogen And D-dimer Levels In Patients With Postoperative Deep Vein Thrombosis

ObjectiveWith the average age of our population, the proportion of China’s elderly population gradually increased hip fracture patients are becoming more common. After accidentally elderly hip fracture, almost all are accompanied by loss of function of the lower limbs to walk, not as surgery, often require a long time to brake in bed, in addition to elderly patients is often associated with various types of underlying diseases, likely to cause lung infections, urinary tract infection, the outcome is even more serious than surgery. And may still exist deformity, pain and movement disorder after fracture healing, so more and more patients chose surgery. But the surgery on the body is a major trauma, and deep vein thrombosis is a common complication after surgery, pulmonary emboli caused bolt may even cause death outcome. Therefore, this study aimed to analyze correlation want before patients with hip fracture surgery-related factors associated with postoperative deep venous thrombosis, and filter out the risk factors, which predict likely, in time, to guide clinical practice.MethodsThrough a retrospective study of TCM Affiliated wide from June 2012 to February 2016,60 years of age, diagnosis with "femoral neck fracture" "intertrochanteric fracture", and in a hospital orthopedic surgical treatment of 63 patients. Discussion on sex, age, fracture, fractures to the preoperative time, fibrinogen, D-dimer, activated partial thromboplastin time, prothrombin time, C-reactive protein, maximum value and postoperative platelet correlation of DVT occurs, the application Excell entry form information and data, and the use of SPSS 19.0 software for statistical analysis. After the first screening of the relevant factors of DVT meaningful entering multiple regression, correlation factors and then by drawing ROC curve to select the optimal range.Results63 patients were collected, the proportion appears after occurrence of DVT was 9.52%(6/63). Wherein the patient gender, age, fracture, fractures to the time before surgery, activated partial thromboplastin time, prothrombin time, C-reactive protein, platelet and postoperative lower extremity DVT was no significant correlation between plasma fibrinogen original, D-dimer gap was statistically significant (P<0.05), and both lower extremities after DVT was positively correlated. Were drawn to the FIB, D-Dimer and their combination prediction ROC curve, the area under its lines were 0.769,0.833,0.877, then three P values were less than 0.05. In sum maximum sensitivity and specificity for the detection of the optimum operating point, the FIB to the optimum operating point of DVT after prediction is 4.275g/L, predicted sensitivity 83.3%, specificity 66.7%false positive rate was 16.7%, the false negative rate was 33.3%, positive predictive value of 20.8%, negative predictive value of 97.4%, Youden index was 50%. D-Dimer for the optimum operating point of DVT after forecast for 3.151ug/ml, at which time the predicted sensitivity of 100% and specificity of 66.7%, the false positive rate of 0% false negative rate was 33.3% the positive predictive value of 24.0% and a negative predictive value of 100%, Youden index was 66.7%. Joint whichever FIB when postoperative DVT forecast>4.275g/L and D-Dimer> when 3.151ug/ml as positive, I was negative, at which time the predicted sensitivity 83.3%, specificity was 89.5%, false the positive rate of 16.7%, the false negative rate was 10.5%, positive predictive value 45.5%, negative predictive value of 98.1%, Youden index was 72.8%.ConclusionThis study shows that:FIB and D-Dimer elderly hip fracture surgery on lower limb DVT were significantly correlated, but the positive predictive value is generally small, there is a high negative predictive value. If at the same time take into account both the joint (FIB> 4.275g/L and D-Dimer> 3.151ug /ml) for elderly hip fracture surgery emergence of DVT forecast to increase significantly. However, due to the small sample size, it does not reflect the overall sample level, and their joint positive predictive value was only 45.5%, remained at a low level, the need to include more factors were analyzed.