1. Mechanical prophylaxis after hip fracture: what is the risk of deep vein thrombosis? A retrospective observational study
- Author
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Shridhar Aithal, Majd B. Protty, Rebecca J. Pettit, Antony Johansen, and Ben Hickey
- Subjects
Male ,Risk ,medicine.medical_specialty ,medicine.medical_treatment ,Deep vein ,Geriatric Medicine ,Compression stockings ,Medicine ,Humans ,Prospective Studies ,Prospective cohort study ,Aged ,Retrospective Studies ,Geriatrics ,Aged, 80 and over ,Venous Thrombosis ,Hip fracture ,Wales ,business.industry ,Hip Fractures ,Research ,Retrospective cohort study ,General Medicine ,medicine.disease ,Thrombosis ,Surgery ,Venous thrombosis ,medicine.anatomical_structure ,Lower Extremity ,Female ,business ,Stockings, Compression - Abstract
Graduated compression stockings carry a potential risk of pressure, vascular and other complications. Current understanding of deep vein thrombosis (DVT) risk leaves it uncertain whether patients with hip fracture should wear stockings on both legs. Objectives To determine the association between the side of the hip fracture and the subsequent occurrence of symptomatic lower limb DVT. Setting Single tertiary trauma centre, Wales. Participants All 3657 patients presenting with hip fracture between 2007 and 2013 were identified from our unit's National Hip Fracture Database. We excluded 404 patients (11.0%) resident outside our catchment area, leaving a total of 3253. Median age was 83 years (±12.4). Primary/secondary outcome measures We cross-linked patient details with Medical Physics records, to identify 634 (19.5%) who had undergone one or more lower-limb Doppler-ultrasound scans at some point during the study period. The distribution rates of DVT were calculated from this resulting data set. Results Many of the total 634 scans were unrelated to the hip fracture, including 225 (35.5%) performed prior to the fracture. We calculated a baseline rate of DVT of 3.7/1000 patients per year, for the 3-month period immediately before the hip fracture. Scans performed following hip fracture showed DVT risk to be highest in the 3-month period after fracture (35.7/1000 patients per year). This resulted from a six-fold increase in DVTs on the side of the fracture (29.5/1000 patients per year, p
- Published
- 2015