Risk factors for symptomatic venous thromboembolism following surgery for closed ankle fractures: A case-control study.


Journal

Foot and ankle surgery : official journal of the European Society of Foot and Ankle Surgeons
ISSN: 1460-9584
Titre abrégé: Foot Ankle Surg
Pays: France
ID NLM: 9609647

Informations de publication

Date de publication:
Aug 2020
Historique:
received: 18 06 2019
revised: 19 07 2019
accepted: 19 08 2019
pubmed: 5 9 2019
medline: 7 1 2021
entrez: 5 9 2019
Statut: ppublish

Résumé

We analyzed risk factors for venous thromboembolism (VTE) within 6 months after surgery for closed ankle fractures. This was a case-control study based on data from chart review in a cohort of patients having open reduction and internal fixation (ORIF) for closed ankle fractures in two large general hospitals 2009-2011. Cases with symptomatic VTE (pulmonary embolism or deep venous thrombosis) were identified in the cohort, and additional cases of VTE were identified by computerized search of discharge diagnoses in the same hospitals in 2004-2008 and 2012-2016. In total, we identified 60 cases with VTE and compared with 240 randomly selected controls among 998 patients without VTE in the cohort. Risk factors were assessed using logistic regression analysis. Among cases, 27 (45%) had pulmonary embolism, 33 (55%) deep venous thrombosis. Those with VTE were older, had higher BMI, had more often a family history of VTE, and more often had antibiotic prophylaxis during surgery than controls. In multivariable logistic regression analysis age/10 (OR 25.75, 95%CI 3.52-188.44, p=0.001), (age/10) The odds of symptomatic VTE within 6 months of ORIF increased with increasing age and BMI, but were lower with increasing comorbidity.

Sections du résumé

BACKGROUND BACKGROUND
We analyzed risk factors for venous thromboembolism (VTE) within 6 months after surgery for closed ankle fractures.
METHODS METHODS
This was a case-control study based on data from chart review in a cohort of patients having open reduction and internal fixation (ORIF) for closed ankle fractures in two large general hospitals 2009-2011. Cases with symptomatic VTE (pulmonary embolism or deep venous thrombosis) were identified in the cohort, and additional cases of VTE were identified by computerized search of discharge diagnoses in the same hospitals in 2004-2008 and 2012-2016. In total, we identified 60 cases with VTE and compared with 240 randomly selected controls among 998 patients without VTE in the cohort. Risk factors were assessed using logistic regression analysis.
RESULTS RESULTS
Among cases, 27 (45%) had pulmonary embolism, 33 (55%) deep venous thrombosis. Those with VTE were older, had higher BMI, had more often a family history of VTE, and more often had antibiotic prophylaxis during surgery than controls. In multivariable logistic regression analysis age/10 (OR 25.75, 95%CI 3.52-188.44, p=0.001), (age/10)
CONCLUSIONS CONCLUSIONS
The odds of symptomatic VTE within 6 months of ORIF increased with increasing age and BMI, but were lower with increasing comorbidity.

Identifiants

pubmed: 31481323
pii: S1268-7731(19)30138-9
doi: 10.1016/j.fas.2019.08.006
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

681-686

Informations de copyright

Copyright © 2019 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.

Auteurs

Knut Stavem (K)

Institute of Clinical Medicine, University of Oslo, Norway; Health Services Research Unit, Akershus University Hospital, Norway; Department of Pulmonary Medicine, Medical Division, Akershus University Hospital, Norway. Electronic address: knut.stavem@medisin.uio.no.

Stein Arve Skjaker (SA)

Section for Orthopaedic Emergency, Orthopaedic Department, Oslo University Hospital, Norway.

Henrik Hoel (H)

Department of Vascular Surgery, Oslo University Hospital, Aker, Norway.

Markus Georg Naumann (MG)

Department of Orthopaedics, Østfold Hospital, Norway.

Ulf Sigurdsen (U)

Department of Orthopaedics, Akershus University Hospital, Norway.

Waleed Ghanima (W)

Institute of Clinical Medicine, University of Oslo, Norway; Department of Medicine, Østfold Hospital, Norway.

Stein Erik Utvåg (SE)

Institute of Clinical Medicine, University of Oslo, Norway; Department of Orthopaedics, Akershus University Hospital, Norway.

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