The incidence of symptomatic venous thromboembolism following hip fractures with or without surgery in Taiwan

Cheng-Han Lee , Tzu-Chieh Lin , Ching-Lan Cheng , Li-Jen Lin , Chyun-Yu Yang , Yea-Huei Kao Yang
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引用次数: 3

Abstract

Background

Information on the incidence of venous thromboembolism (VTE) following hip fractures in Asia is rare. This study will investigate the epidemiology of symptomatic VTE in Taiwanese patients experiencing hip fractures.

Methods and results

We used Taiwan's National Health Insurance Research Database to retrospectively identify patients (≧ 45 years) who experienced hip fractures from 1998 to 2007 and were followed up for 3 months after the discharge. Logistic regression analysis determined the independent risk factors of symptomatic VTE after the fractures. We identified 134,034 patients (mean age: 76.2 ± 9.7 years; female: 57.8%) who experienced hip fractures, 83.2% of whom underwent hip surgery. The overall pharmacological thromboprophylaxis rate was 2.7%. The mean length of stay was 11.3 ± 7.9 days. The 3-month cumulative incidence of symptomatic VTE was 77 events per 10,000 persons. Multivariate analysis showed that previous DVT, previous PE, varicose veins, cancer, heart failure, renal insufficiency, and older age were independent risk factors of developing VTE.

Conclusions

The incidence of symptomatic VTE after hip fractures is low in Taiwan. Patients rarely received pharmacological thromboprophylaxis following hip fractures. Universal thromboprophylaxis for patients experiencing hip fractures was not necessary in Taiwan, but it should be considered in high-risk populations.

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台湾髋骨骨折伴或不伴手术后症状性静脉血栓栓塞的发生率
背景:关于亚洲髋部骨折后静脉血栓栓塞(VTE)发生率的信息很少。本研究旨在探讨台湾髋部骨折患者的症状性静脉血栓栓塞流行病学。方法与结果采用台湾健保研究数据库,回顾性分析1998 ~ 2007年间发生髋部骨折的患者(≥45岁),出院后随访3个月。Logistic回归分析确定骨折后症状性静脉血栓栓塞的独立危险因素。我们确定了134034例患者(平均年龄:76.2±9.7岁;女性:57.8%)经历过髋部骨折,其中83.2%接受过髋部手术。总体药理学血栓预防率为2.7%。平均住院时间11.3±7.9天。症状性静脉血栓栓塞的3个月累积发生率为每10000人77例。多因素分析显示,既往DVT、既往PE、静脉曲张、癌症、心力衰竭、肾功能不全、年龄是发生VTE的独立危险因素。结论台湾地区髋部骨折后出现症状性静脉血栓栓塞的发生率较低。患者很少在髋部骨折后接受药物血栓预防治疗。在台湾,髋部骨折患者不需要普遍的血栓预防,但在高危人群中应予以考虑。
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