Usefulness of clinical predictors for preoperative screening of deep vein thrombosis in hip fractures

BMC Musculoskeletal Disorders

Research Article

Noratep Kulachote¹  Pongsthorn Chanplakorn¹  Chanyut Suphachatwong¹  Patarawan Woratanarat¹  Paphon Sa-ngasoongsong¹  Sorawut Thamyongkit²  Kitchai Luksameearunothai³  Praman Fuangfa⁴ 

[1] Department of Orthopedics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270, Rama VI Road, Ratchathewi, 10400, Bangkok, Thailand;Department of Orthopedics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270, Rama VI Road, Ratchathewi, 10400, Bangkok, Thailand;Chakri Naruebodindra Medical Institute, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand;Department of Orthopedics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270, Rama VI Road, Ratchathewi, 10400, Bangkok, Thailand;Department of Orthopaedics, Faculty of Medicine Vajira Hospital, Navamindrahiraj University, Bangkok, Thailand;Department of Radiology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand;

关键词: Preoperative screening;    Deep vein thrombosis;    Hip fracture;    Wells score;    Caprini score;   

DOI  :  10.1186/s12891-017-1582-5

 received in 2017-01-05, accepted in 2017-05-15,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundRecent studies showed that preoperative deep vein thrombosis (DVT) was common after hip fracture (HF), and preoperative DVT screening has been recommended for preventing the fatal DVT-related complications, especially in elderly HF patients with high surgical risk. However, to our knowledge, no previous studies have demonstrated the correlation between the clinical risk predictors and preoperative DVT. Therefore, this study aimed to correlate those clinical predictors related to DVT risk assessment with the incidence of preoperative DVT.MethodsA prospective study was conducted, between July 2015 and June 2016, in 92 HF patients. All patients were evaluated for the DVT-related risk, as patients’ characteristics, clinical signs, D-dimer, DVT risk assessment score (Wells score and Caprini score), and then underwent doppler ultrasonography preoperatively. The incidence of preoperative DVT was correlated with each clinical risk predictor, and then significant factors were calculated for diagnostic accuracy.ResultsThe average patients’ age was 78 ± 10 years. Sixty-eight patients (74%) were female. The incidence of preoperative DVT was 16.3% (n = 15). The median time from injury to doppler ultrasonography was 2 days (range 0–150 days). DVT group showed a significantly higher in Wells score and Caprini score compared to the non-DVT group (p < 0.05 all). Sensitivity and specificity of Wells score ≥ 2 and Caprini score ≥12 were 47 and 81, and 93 and 35%, respectively.ConclusionDVT risk assessment may be helpful for stratifying the risk of preoperative DVT in elderly HFs. Those with Caprini score ≥ 12 should be screened with doppler ultrasonography preoperatively. Those with Wells score 0–1 had low risk for preoperative DVT, so the surgery could perform without delay.

【 授权许可】

CC BY   
© The Author(s). 2017