Preoperative deep vein thrombosis in elderly hip fracture patients: a retrospective observational study

Abstract Objective: Deep vein thrombosis (DVT) is a frequent and life-threatening complication in elderly patients with hip fractures. The purpose of this study was to identify the incidence, predilection site, and associated risk factors of preoperative DVT. Methods: This was a retrospective study of elderly patients who presented with hip fractures at our institution between January 2020 and December 2021. All patients received antithrombotic chemoprophylaxis during hospitalization. Patients were categorized into the non-DVT group and the DVT group based on ultrasonography results. The demographic data and laboratory findings at the admission of the two groups were extracted from electronic medical records. Univariate analysis and multivariate logistic regression analyses were conducted to obtain the associated risk factors for DVT. Results: A total of 516 elderly hip fracture patients were included in the study, of whom 64 (12.4%) developed preoperative DVT. Of the 64 patients, 41 (64.1%) patients developed DVT in the injured limb, 11 (17.2%) patients had DVT in the uninjured limb, and 12 (18.8%) cases of DVT occurred on both sides. Multivariate analysis revealed that hypertension (OR, 2.5, 95%CI, 1.4 to 4.7; P=0.003), aged-adjusted Charlson comorbidity index (ACCI) ≥ 6 (OR, 1.4, 95%CI, 1.1 to 1.8; P=0.009), D-dimer at admission ≥ 2.5mg/L (OR, 3.1, 95%CI, 1.7 to 5.9; P=0.001), the time interval between injury and admission (OR, 1.1, 95%CI, 1.0 to 1.2; P=0.003), and the time interval between injury and operation (OR, 1.1, 95%CI, 1.0 to 1.1; P=0.002) were independent risk factors for preoperative DVT. Conclusions: Elderly patients with hip fractures should be evaluated for the risk of DVT as soon as possible after admission. Providing effectively preventive measures to patients at high risk of DVT can avoid the occurrence of DVT to some extent.