Related Research In Perioperative Of Hip Fracture Deep Vein Thrombosis

Objectives 1 To study the risk factors of deep venous thrombosis in patients with hip fracture and to explore the independent risk factors of deep vein thrombosis.Methods: Thrombosis risk assessment.2 Individualized Caprini thrombosis risk scale was used to evaluate the effectiveness of venous thrombosis risk assessment in patients with hip fractures.Methods This study was retrospective case-control study,including two parts.1 568 patients with hip fractures were selected from Tangshan Second Hospital from January 2012 to December 2016,including 140 DVT patients and 428 non-DVT patients.The general clinical data,surgical-related data and relevant risk factors of DVT were collected for the patients who met the inclusion criteria.The data were compared using independent samples t test,count data comparison between the use of ?~2 test,univariate analysis showed that statistical significance of DVT risk factors into multivariate logistic regression analysis.2 The individualized Caprini thrombosis risk assessment was used to evaluate hip fracture patients who met the inclusion criteria and divided into four groups according to the score: low-risk group,intermediate-risk group,high-risk group and high-risk group.Four groups were compared using ?~2 test,according to the results of ?~2 test using multivariate Logistic regression analysis.The patients in the extremely high-risk group were divided into five subgroups,seven to eight subgroups and nine subgroups according to the score.The comparison between the two groups was conducted by ?~2 test.Results 1 The risk factors of perioperative DVT in patients with hip fractures were analyzed by univariate analysis,including age,BMI,history of VTE,history of surgery(one month),perioperative anticoagulation,central venous catheterization,operation time,blood transfusion acetabulum fractures and femoral neck fractures were statistically significant in both groups(P<0.05).Significant risk factors selected in the univariate analysis were defined as independent variables and assigned;The dependent variable was whether the patient had DVT or not,and Logistic regression analysis was performed.BMI? 30 Kg / m2,history of VTE,history of surgery(within one month),perioperative anticoagulant therapy,central venous catheterization,operation time?200 min,the standard values of the introduced variables were 0.05,acetabulum fracture and bed rest time ?7 days were correlated with the incidence of DVT in the patients with hip fractures,there was statistical significance(P<0.05).The risk score was(8.6 ± 3.4)in the DVT group and(4.6 ± 2.2)in the non-DVT group.The DVT group was more likely to be in the high-risk group than in the high-risk group(55.71%).The proportion of patients in the two groups was significantly higher than that in the low-risk group and middle-risk group(45.55%).The ?~2 test showed that the difference was statistically significant(P<0.001),the perioperative DVT Logistic regression analysis was used to determine the thrombotic risk of patients with hip fractures as the dependent variable and the perioperative thrombotic risk stratification as the independent variable.Logistic regression analysis showed that the risk factors of DVT were high-risk group and highest risk group in Caprini thrombosis risk assessment scale.The risk of thrombosis was higher in patients with hip fractures with high Caprini risk score.Peripheral hip fractures Stage of Caprini thrombosis in the highest risk group were re-grouped,that is divided into 5-6 group,7-8 group,?9 group.The results of ?~2 test showed that the risk of DVT in patients with hip fractures also increased with the increase of thrombotic risk points,but there was no significant difference between the two groups.Conclusions 1 In this study,we found that Age> 75 years old,BMI? 30 Kg / m2,VTE history,surgical history(within one month),perioperative anticoagulation therapy,central venous catheterization,operation time ? 200 min,acetabulum fracture,postoperative bedridden time ? 7 Day is an independent risk factor for perioperative DVT in patients with hip fractures.2 The individualized Caprini Risk Assessment Scale was able to screen high-risk patients in DVT,which was useful for the classification and prophylaxis of DVT in patients with clinical hip fractures.However,the reassortation of patients with the highest risk groups showed that the probability of DVT was increased with the increase in risk scores,but there was no need to reclassify patients in the highest risk groups.