Risk Factors Analysis Of Deep Venous Thrombosis After Hip Arthroplasty In The Elderly Population

Objectives To investigate the major risk factors that cause deep vein thrombosis in lower limbs after traumatic hip arthroplasty in middle-aged and elderly patients and further evaluate the importance of each factor so as to provide referable theoretical basis for the prevention of deep vein thrombosis.Methods A hospital-based case-control study was carried out. 154 cases were selected as a case group who suffered from deep vein thrombosis in lower limbs of middle-aged and elderly patients after traumatic hip arthroplasty, and 154 cases who also received traumatic hip arthroplasty but without postoperative thrombosis as a control group. All those patients were from the Affiliated Orthopedics Hospital of North China University of Science and Technology during January 2010 to September 2014. Investigation was conducted concerning each patient's gender, age, smoking history, blood type, BIM,hypertension history, C-reactive protein, APTT, PT, FIB, TT, D-dimer, CHOL, TG,medication to prevent thrombus, type of anesthesia, surgical approach, operation time(24-hour format), type of prosthesis, fixing method of prosthesis, blood loss, CPM and other relevant circumstances. The collected and processed medical records were used to establish a standard database by SPSS. Mean standard deviation( x ±s) was used to evaluate quantitative data and T-test was carried on to compare the two groups. In addition, Chi-square test was used to evaluate qualitative data. Statistically significant variables of univariate analysis were substituted into unconditional multivariate Logistic regression analysis, and the main effect equation was established by stepwise regression,using SPSS17.0 statistical software package for data analysis.Results 1 High risk factors of DVT( deep vein thrombosis) after artificial hip replacement surgery consist: Hypertension( OR=4.09, 95% CI 1.57~10.67,P=0.00) ? Spinal anesthesia and general anesthesia( OR=7.07, 95% CI2.54~19.66,P=0.00)?Ways of prosthesis fixed including Biology and bone cement( OR=5.24, 95% CI 1.03~26.64, P=0.05) ? Postoperative D-dimer level( OR=5.63, 95% CI 2.97~10.64, P=0.00) ? Postoperative fibrinogen level(OR=1.25,95% CI 1.01~1.55,P=0.04); Protective factors includes: whether or not it was preventive administration( OR=0.11, 95% CI 0.03~0.47, P=0.00) ?whether or not CPM was applied(OR=0.32,95% CI 0.19~0.80,P=0.02). 2 The research finds that deep vein thrombosis caused by traumatic hip arthroplasty for 308 patients has no association with gender, four preoperative coagulation items, preoperative D-dimer, C-reactive protein, TG, surgical approach or Intraoperative blood loss( P>0.05).Conclusions 1 Various factors are found to affect DVT(deep vein thrombosis)after artificial hip replacement surgery.