Prevalence and risk factors of symptomatic venous thromboembolism in distal femur fractures

Wei Mao; Joel Xue Yi Lim; Jiong Hao Tan; Shi-Min Chang; Choon Chiet Hong

doi:10.4103/singaporemedj.SMJ-2023-265

Prevalence and risk factors of symptomatic venous thromboembolism in distal femur fractures

Singapore Med J. 2024 Oct 4. doi: 10.4103/singaporemedj.SMJ-2023-265. Online ahead of print.

Authors

Wei Mao^{1

2

3

4}, Joel Xue Yi Lim^{2

3}, Jiong Hao Tan^{2

3}, Shi-Min Chang¹, Choon Chiet Hong^{2

3}

Affiliations

¹ Department of Orthopaedic Surgery, Yangpu Hospital, School of Medicine, Tongji University, China.
² Department of Orthopaedic Surgery, National University Hospital, National University Health System, Singapore.
³ Department of Orthopaedic Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
⁴ Department of Orthopaedics, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.

PMID: 39363517
DOI: 10.4103/singaporemedj.SMJ-2023-265

Abstract

Introduction: There is a paucity of published research on symptomatic venous thromboembolism (sVTE) after distal femur fractures (DFFs). This study aimed to explore the prevalence and risk factors of sVTE in DFFs.

Methods: We identified a total of 131 patients who underwent DFF surgeries without routine pharmacological thromboprophylaxis between October 2007 and November 2016. Cases of sVTE included symptomatic pulmonary embolism (sPE) and symptomatic deep vein thrombosis (sDVT). Patients with sVTE were compared to those without, and differences in demographics and fracture-related characteristics were explored. Multivariate logistic regression was used to eliminate confounding factors.

Results: Of the 131 patients, 20 (15.3%) had sVTE, of whom 16 (12.2%) had sDVT and six (4.6%) had sPE (two patients had both sPE and sDVT). Notably, 17 (85.0%) sVTE patients were aged ≥60 years, while only 62 (55.9%) non-sVTE patients were aged ≥60 years (P = 0.014). Fourteen (82.4%) patients with sVTE had body mass index (BMI) ≥25 kg/m2, while 49 (53.3%) patients without sVTE had BMI ≥25 kg/m2 (P = 0.032). Multivariate logistic regression demonstrated that age ≥60 years (adjusted odds ratio [OR] 5.05; P = 0.040) and BMI ≥25 kg/m2 (adjusted OR 3.92; P = 0.045) were independently associated with a higher risk of sVTE after DFF.

Conclusion: The prevalence of sVTE in DFFs is high at 15.3%. Advanced age (≥60 years) and being overweight (BMI ≥25 kg/m2) were two independent risk factors for sVTE in DFFs. The use of routine pharmacological thromboprophylaxis should be considered as a preventative measure.