Liyan Wang
Australian National University Medical School, Australia
Title: Case series of venous thromboembolism (VTE) in hospitalised hip fracture patients despite thromboprophylaxis: incidence, outcome and risk factors
Biography
Biography: Liyan Wang
Abstract
Introduction: Patients undergoing hip fracture (HF) surgery have the highest rates of postoperative deep venous thrombosis (DVT) and pulmonary embolism (PE). In a proportion of HF patients VTE occurs even despite postoperative thromboprophylaxis; the incidence, outcome and risk factors for this complication remain unknown.
Observations & Analysis: We report a case serious of 36 (19 female, 17 males) HF patients (mean age 79.1±10.0 years) who developed VTE despite receiving thromboprophylaxis with enoxaparin (n=31), heparin (n=4) or apixaban (n=1). VTE occurred in 36 (2.24%) of 1610 consecutive HF patients on average 6.9 days postoperatively. PE was diagnosed in 20 patients, symptomatic DVT in 11 and both complications in five subjects; six (16.7%) patients had a fatal outcome. Comparison of patients with and without VTE (452 randomly selected HF patients) showed no statistically significant differences in prevalence of 12 chronic comorbid conditions and lifestyle factors, 12 medications used and 28 blood parameters. Multivariate analysis (adjusted for age and all variables with p<0.100 on univariate analysis) identified six independent risk factors for VTE: receiving tranexamic acid (OR 17.5, p=0.023), albumin >33 g/L (OR 27.8, p<0.001), history of malignancy (OR 4.1, p=0.013), low alcohol consumption (<3 times/week, OR 5.3, p<0.010), male gender (OR 2.7, p=0.025) and, non-A blood group (OR 2.3, p=0.099).