High prevalence of deep vein thrombosis in elderly hip fracture patients with delayed hospital admission
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Deep vein thrombosis (DVT) is a common complication in hip fracture patients, associated with significant morbidity and mortality. Research has focused on postoperative DVT, with scant reports on preoperative prevalence. The aim of this study was to describe the prevalence of preoperative DVT in patients accessing medical care ≥ 48 h after a hip fracture.
We included elderly patients admitted ≥ 48 h after sustaining a hip fracture, between September 2015 and October 2017. Patients with a previous episode of DVT, undergoing anticoagulation therapy, with pathologic fractures or undergoing cancer treatment were excluded. Of 273 patients, 59 were admitted at least 48 h after the fracture. DVT screening by Doppler ultrasound of both lower extremities was carried upon hospital admission. We recorded age, sex, Charlson comorbidity index and ASA score, fracture type, time since injury, time from admission to surgery and total length of hospital stay.
We studied 41 patients, 79 (± 10.34) years old. The delay from injury to admission was 120 h (48–696 h). Seven patients (17.1%) had a DVT upon admission. There were no significant differences between patients with and without DVT, regarding time from admission to surgery or the total length of the hospital stay.
The prevalence of DVT in patients admitted ≥ 48 h after a hip fracture was 17.1%. The diagnosis and management of DVT did not increase time to surgery or hospital stay. Our results suggest routine screening for DVT in patients consulting emergency services ≥ 48 h after injury.
KeywordsThromboprophylaxis Hip fracture Deep vein thrombosis Orthogeriatrics
FB, DS, MJL and IK contributed with study design and development. FB, GV, MJL and IK contributed with data collection, interpretation and analysis. Document writing was done by FB and critically analyzed and revised by GV, DS, MJL, TZ and IK. All authors approved the final state of this manuscript.
No funding was received for the development of this study.
Compliance with ethical standards
Conflict of interest
Francisco Bengoa MD, Gerardo Vicencio MD, María Jesús Lira, Tomás Zamora MD and Ianiv Klaber MD declare that they have no conflict of interest. Dr. Daniel Schweitzer has received a speaker honorarium from Zimmer Biomet and DePuy Synthes.
This study was approved by the institutional review board (No. 170628010).
Informed consent was dispensed by the review board.
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