Incidence and risk factors for venous thromboembolism in patients with nonsurgical isolated lower limb injuries |
| |
Authors: | Riou Bruno Rothmann Christophe Lecoules Nathalie Bouvat Eric Bosson Jean-Luc Ravaud Philipe Samama Charles Marc Hamadouche Moussa |
| |
Institution: | 1. Service d''Accueil des Urgences, Centre Hospitalo-Universitaire (CHU) Pitié-Salpêtrière, Université Pierre et Marie Curie (Paris 6), Assistance-Publique Hôpitaux de Paris (AP-HP), Paris, France;2. Service d''accueil des Urgences, Centre hospitalier régional (CHR) Notre Dame de Bon Secours, Metz, France;3. Service des Urgences, CHU Purpan, Toulouse, France;4. Unité Fonctionnelle de Traumatologie du Sport, Hôpital Sud, CHU de Grenoble, France;5. Service d''Informatique Médicale, CHU Grenoble, Unité mixte de recherche CNRS 5525, Université Joseph Fourier, Grenoble, France;6. Département d''épidémiologie, biostatistiques et recherche clinique, INSERM E03 57, CHU Bichat-Claude Bernard, AP-HP, Université Denis Diderot (Paris 7), Paris, France;g Département d''anesthésie-Réanimation, CHU Avicenne, AP-HP, Université Léonard de Vinci (Paris 13), Bobigny, France;h Service de Chirurgie Orthopédique et Traumatologique, CHU Cochin-Port Royal, AP-HP, Université René Descartes (Paris 5), Paris, France |
| |
Abstract: | PurposeThe aim of our study was to determine the incidence of venous thromboembolism (VTE) in patients with nonsurgical isolated lower limb injury and to determine the risk factors associated with the development of the condition.MethodsThis observational study was conducted in French hospital emergency departments (EDs). Patients older than 18 years presenting with nonsurgical isolated lower limb injury below the knee in the ED were included. Deep VTE was diagnosed with compression ultrasound. The final diagnosis of VTE was confirmed by an expert panel.ResultsThree thousand six hundred ninety-eight patients were included, and compression ultrasound examination was obtained in 2761 (75%) of them who were retained in the analysis. Deep venous thrombosis occurred in 177 patients and nonfatal pulmonary embolism in 1 patient. The incidence of VTE, mainly distal and asymptomatic, was 6.4% (95% confidence interval, 5.5%-7.4%). In a multivariate analysis, predictive variables of VTE were age of at least 50 years (odds ratio, 3.14; P < .0001), rigid immobilization (odds ratio, 2.70; P < .0001), no weight bearing (odds ratio, 4.11; P = .0015), and severe injury (odds ratio, 1.88; P = .0002). The discriminant analysis showed that age was the only variable independent of an antithrombotic prophylaxis associated with VTE.ConclusionThe incidence of VTE was 6.4% in patients with nonsurgical lower limb injury. Rigid immobilization, recommendation not to bear weight, severe injury, and age of at least 50 years should be considered as risk factors for VTE. Emergency physicians should also take age into account when prescribing antithrombotic prophylaxis. |
| |
Keywords: | |
本文献已被 ScienceDirect PubMed 等数据库收录! |
|