Retrospective Study On Deep Venous Thrombosis In Patients With Fracture

Objective: To study the incidence of deep vein thrombosis (DVT) and related factors in patients with fracture; To analyse the pros and cons of different anticoagulant regimens; To provide valuable draw and reference for the prevention and treatment of DVT after fracture.Methods:Analysis the DVT in patients with fracture caused by trauma:608hospitalized patients with fracture caused by trauma who were to undergo Doppler ultrasound during the first occurrence of DVT were enrolled in the research. The causes of injury, fracture site, type of DVT, and with or without the combined risk factors were analysed; The anticoagulant efficacy was compared among groups of different dosing regimens (LMWH QD, QD-BID and BID) and between the groups in which patients with or without inferior vena cava filter (IVCF) implant.Analysis of DVT in lower limb fracture patients with cardiovascular disease:584cases of hip fracture were enrolled in the research. They were divided into CVD group and NCVD group depending on whether associated with cardiovascular disease. Then the patients in CVD group was divided into three subgroups, group A (only with essential hypertension), group B (only with coronary heart disease) and group C (with essential hypertension and coronary heart disease simultaneously). The incidence of lower extremity DVT was compared between CVD group and NCVD group, and among A, B, C three subgroups. The incidence of DVT in the lower extremities in different time periods after fracture and the occurrence of different ages of DVT in patients with fracture were compared.Results:l.The top three causes of injury caused by fracture were falls, car accidents and fall injury, accounting for88.97%of all causes of injury.2.The multiple fractures had a highest occurrence rate, the second was femoral neck fractures and the third was intertrochanteric fractures.the fractures of three parts reached63.66%of all fractures.3. The average age of patients with DVT (67.1±7.5years) was significantly higher than patients without DVT (61.8±6.2years). The incidence of DVT was higher in patients aged over50years old than patients aged less than50years old.4. Approximately60%DVT patients had one or more risk factors. The incidence of hypertension, coronary heart disease and smoking reached70.39%of all the risk factors.5. Incidence of lower extremity DVT within7days after fracture was greater than that from7to14days and over14days. Incidence of lower extremity DVT in patients of CVD group was significantly higher than that in patients in NCVD group.6. Lower extremity DVT in peripheral were common, accounting for78.62%of all lower extremity DVT, the DVT of central and mixed were7.07%and14.31%.7. The complete recanalization rate in BID dosing (69.01%) of subcutaneous low molecular weight heparin was better than than QD or QD-BID dosing (43.75%vs42.78%respectively), P<0.05. No significant difference between the QD or QD-BID dosing groups, P>0.05.8. The complete recanalization rate after the anticoagulant therapy in central and peripheral DVT was significantly higher than the mixed DVT (65.12%,55.44%and28.74%respectively), while no significant difference between central and peripheral DVT.9. The complete recanalization rate in DVT patients with risk factors (46.59%) was lower than those without risk factors (61.00%),,P<0.05.10.The complete recanalization rates after anticoagulant therapy were no difference with IVCF implant or without (55.90%vs50.13%respectively).11.No gender difference in complete recanalization rate after anticoagulant therapy in patients with lower extremity DVT, P>0.05.Conclusions:1. Lower extremity DVT is most common in peripheral, and the common period of DVT was with7days after the fracture.2. Patients with cardiovascular disease and aged over50years old suffered from lower extremity DVT more likely after fracture.3. Complete Recanalization rate of LMWH in the treatment for low extremity DVT after fracture was high, and twice a day had best curaive effect.4. The anticoagulation effect in central type and peripheral type DVT were better than mixed type DVT.5. The anticoagulation effect could be affected by risk factors. There was no difference between genders in anticoagulation. 6. IVCF implanted had no influence in anticoagulation.