THE EFFECT OF THROMBOPROPHYLAXIS ON THE INCIDENCE OF POSTOPERATIVE VENOUS THROMBOEMBOLISM FOLLOWING HIGH-ENERGY FRACTURES OF THE LOWER LEG: A RETROSPECTIVE COHORT STUDY
Notice bibliographique
Résumé
Venous thromboembolisms (VTE) (deep vein thrombosis [DVT] or pulmonary embolism [PE]) are frequent complications following high-energy fractures. In this context, VTEs are most often due to vascular injury and/or to immobilization. Post-operative thromboprophylaxis is recommended for patients presenting with a high-energy pelvic or hip fracture whereas patients with ankle and foot fractures do not need chemoprophylaxis. Guidelines are not as clear when it comes to patients presenting with high-energy fractures around then knee. The objective of this study was to describe the incidence of post-operative VTEs in patients admitted for high-energy fractures around the knee. We included in this retrospective cohort study all adult patients who underwent surgery for a high-energy fracture around the knee between 2011 and 2020 at (hospital name). Included fractures were of the femoral diaphysis; the distal femur; the proximal tibia; the tibial shaft; as well as knee dislocations. Patients presenting with fractures that required thromboprophylaxis or with a pathological fracture as well as patients under anticoagulation for a pre-existing condition were excluded from this study. Collected data concerned demographics, hospitalization and surgery dates, presence of VTE risk factors, thromboprophylaxis, and the occurrence of VTE following surgery were collected. We analyzed 985 patient files out of the 2217 identified. Seventy-three patients (7.4%) suffered a VTE (63 DVT, 17 PE), of which 59 (80%) had received some form of thromboprophylaxis. Patients who suffered a VTE were significantly older (52.3 vs 43.7 years old; p < 0 .0001) or had a previous history of either DVT or PE (p=0.0009). Twenty-nine had to have an external fixator prior to definitive fracture fixation (p < 0 .0001) and half were polytraumatized (p=0.04). Distal femur fractures were at higher risk of VTE (OR 2.19; 95% CI 1.18–4.09) In our cohort, patients more at risk of suffering from a VTE following surgery for high-energy lower leg fractures were significantly older; had a previous history of VTE; were polytraumatized; had to have an external fixator; or presented with a distal femur fracture. Most patients who suffered a VTE were under thromboprophylaxis. More aggressive thromboprophylaxis should be administered to high-risk patients.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,002 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,001 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,001 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».