Incidence of deep vein thrombosis and pulmonary embolism in closed foot and ankle fractures treated with conservative versus surgical management: A nationwide analysis
Though there is extensive research on recovery and outcomes of proximal joint fractures, such as hip and knee, there is a paucity of such research in foot and ankle fractures and a lack of uniform data on the incidence of venous thromboembolism (VTE). This is a retrospective cohort study that seeks...
Gespeichert in:
| Veröffentlicht in: | Injury 2024-12, Vol.55 (12), p.111859, Article 111859 |
|---|---|
| Hauptverfasser: | , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | |
|---|---|
| container_issue | 12 |
| container_start_page | 111859 |
| container_title | Injury |
| container_volume | 55 |
| creator | Kohli, Meera Atodaria, Kuldeepsinh P. Patel, Rajeshkumar Brahmabhatt, Shyam Goyal, Aakash R. Raval, Neha |
| description | Though there is extensive research on recovery and outcomes of proximal joint fractures, such as hip and knee, there is a paucity of such research in foot and ankle fractures and a lack of uniform data on the incidence of venous thromboembolism (VTE). This is a retrospective cohort study that seeks to investigate the incidence of VTE following surgically versus conservatively treated foot and ankle fractures
This study included all adult-patient hospitalizations with International Classification of Disease 10th Revision diagnosis codes related to closed foot and ankle fractures as a primary diagnosis in the National Inpatient Sample, an administrative database part of the Healthcare Cost and Utilization Project, for a total of 209,595 cases. Multivariate binary logistic regression was performed to determine the effect of age, gender, past medical history of venous thromboembolism (PMHVTE), Charlson Comorbidity Index, race, surgery, and transfusion of red cell products on the incidence of deep venous thrombosis (DVT) and pulmonary embolism (PE).
Our study found an overall incidence of DVT and PE to be 0.4 % and 0.3 %, respectively, following foot or ankle fracture. Conservative management was found to have an increased relative risk of DVT and PE of 2.02 and 1.15, respectively. This difference persisted on performing inverse probability treatment weighting (IPTW) analysis to account for confounders. PMHVTE and requirement of blood transfusion was associated with an increased odds ratio (OR) of 3.41 and 3.217, respectively. Cases identified as Black and Asian/Pacific Islander also had an increased OR of DVT.
The results of this study demonstrate that surgical management of foot and ankle fractures is associated with a lower relative risk of VTE compared to medical management. PMHVTE and transfusion of red cell products increase the odds of VTE following either form of intervention. |
| doi_str_mv | 10.1016/j.injury.2024.111859 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_3118303859</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0020138324005886</els_id><sourcerecordid>3118303859</sourcerecordid><originalsourceid>FETCH-LOGICAL-c241t-737e3a848f7322879da6e36e26600af636024ce992faaa2ed7e0b7c1ead9228e3</originalsourceid><addsrcrecordid>eNp9kctu1DAUhi0EotPCGyDkJZsMvgQnYYFUVUArVeqmXVtn7JPWg2MPtjPVPFFfEw8pLLuyZH3n9n-EfOBszRlXn7drF7ZzOqwFE-2ac95_GV6RFe-7oWFCda_JijHBGi57eUJOc94yxjsm5VtyIodWSNWxFXm6CsZZDAZpHKlF3NE9ukDLQ4rTJmaXKQRLd7OfYoB0oFh_vcsTrZDxMaOlY4zlLwXhl0c6JjBlTphpSQilAo-uPFATQ8a0h-L2WGekPGea53TvDHg6QYB7nDCUr_SchgrF8Fj3qi3BH-oW78ibEXzG98_vGbn78f324rK5vvl5dXF-3RjR8tJ0skMJfduPnRSiRmFBoVQolGIMRiVVDcvgMIgRAATaDtmmMxzBDpVHeUY-LX13Kf6eMRc9uWzQewgY56xlzVkyWbOuaLugJsWcE456l9xUM9Kc6aMivdWLIn1UpBdFtezj84R5M6H9X_TPSQW-LQDWO_cOk87GHQ1Zl9AUbaN7ecIfGS6o4g</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3118303859</pqid></control><display><type>article</type><title>Incidence of deep vein thrombosis and pulmonary embolism in closed foot and ankle fractures treated with conservative versus surgical management: A nationwide analysis</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals</source><creator>Kohli, Meera ; Atodaria, Kuldeepsinh P. ; Patel, Rajeshkumar ; Brahmabhatt, Shyam ; Goyal, Aakash R. ; Raval, Neha</creator><creatorcontrib>Kohli, Meera ; Atodaria, Kuldeepsinh P. ; Patel, Rajeshkumar ; Brahmabhatt, Shyam ; Goyal, Aakash R. ; Raval, Neha</creatorcontrib><description>Though there is extensive research on recovery and outcomes of proximal joint fractures, such as hip and knee, there is a paucity of such research in foot and ankle fractures and a lack of uniform data on the incidence of venous thromboembolism (VTE). This is a retrospective cohort study that seeks to investigate the incidence of VTE following surgically versus conservatively treated foot and ankle fractures
This study included all adult-patient hospitalizations with International Classification of Disease 10th Revision diagnosis codes related to closed foot and ankle fractures as a primary diagnosis in the National Inpatient Sample, an administrative database part of the Healthcare Cost and Utilization Project, for a total of 209,595 cases. Multivariate binary logistic regression was performed to determine the effect of age, gender, past medical history of venous thromboembolism (PMHVTE), Charlson Comorbidity Index, race, surgery, and transfusion of red cell products on the incidence of deep venous thrombosis (DVT) and pulmonary embolism (PE).
Our study found an overall incidence of DVT and PE to be 0.4 % and 0.3 %, respectively, following foot or ankle fracture. Conservative management was found to have an increased relative risk of DVT and PE of 2.02 and 1.15, respectively. This difference persisted on performing inverse probability treatment weighting (IPTW) analysis to account for confounders. PMHVTE and requirement of blood transfusion was associated with an increased odds ratio (OR) of 3.41 and 3.217, respectively. Cases identified as Black and Asian/Pacific Islander also had an increased OR of DVT.
The results of this study demonstrate that surgical management of foot and ankle fractures is associated with a lower relative risk of VTE compared to medical management. PMHVTE and transfusion of red cell products increase the odds of VTE following either form of intervention.</description><identifier>ISSN: 0020-1383</identifier><identifier>ISSN: 1879-0267</identifier><identifier>EISSN: 1879-0267</identifier><identifier>DOI: 10.1016/j.injury.2024.111859</identifier><identifier>PMID: 39423670</identifier><language>eng</language><publisher>Netherlands: Elsevier Ltd</publisher><subject>Adult ; Aged ; Ankle Fractures - complications ; Ankle Fractures - epidemiology ; Ankle Fractures - surgery ; Conservative Treatment - statistics & numerical data ; Deep venous thrombosis ; Female ; Foot and ankle fracture ; Foot Injuries - complications ; Foot Injuries - epidemiology ; Foot Injuries - surgery ; Fractures, Closed - epidemiology ; Fractures, Closed - surgery ; Humans ; Incidence ; Male ; Middle Aged ; Orthopaedics ; Postoperative Complications - epidemiology ; Pulmonary embolism ; Pulmonary Embolism - epidemiology ; Pulmonary Embolism - etiology ; Retrospective Studies ; Risk Factors ; Trauma ; United States - epidemiology ; Venous thromboembolism ; Venous Thrombosis - epidemiology</subject><ispartof>Injury, 2024-12, Vol.55 (12), p.111859, Article 111859</ispartof><rights>2024 Elsevier Ltd</rights><rights>Copyright © 2024 Elsevier Ltd. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c241t-737e3a848f7322879da6e36e26600af636024ce992faaa2ed7e0b7c1ead9228e3</cites><orcidid>0009-0005-8163-2628 ; 0009-0001-5132-836X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0020138324005886$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39423670$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kohli, Meera</creatorcontrib><creatorcontrib>Atodaria, Kuldeepsinh P.</creatorcontrib><creatorcontrib>Patel, Rajeshkumar</creatorcontrib><creatorcontrib>Brahmabhatt, Shyam</creatorcontrib><creatorcontrib>Goyal, Aakash R.</creatorcontrib><creatorcontrib>Raval, Neha</creatorcontrib><title>Incidence of deep vein thrombosis and pulmonary embolism in closed foot and ankle fractures treated with conservative versus surgical management: A nationwide analysis</title><title>Injury</title><addtitle>Injury</addtitle><description>Though there is extensive research on recovery and outcomes of proximal joint fractures, such as hip and knee, there is a paucity of such research in foot and ankle fractures and a lack of uniform data on the incidence of venous thromboembolism (VTE). This is a retrospective cohort study that seeks to investigate the incidence of VTE following surgically versus conservatively treated foot and ankle fractures
This study included all adult-patient hospitalizations with International Classification of Disease 10th Revision diagnosis codes related to closed foot and ankle fractures as a primary diagnosis in the National Inpatient Sample, an administrative database part of the Healthcare Cost and Utilization Project, for a total of 209,595 cases. Multivariate binary logistic regression was performed to determine the effect of age, gender, past medical history of venous thromboembolism (PMHVTE), Charlson Comorbidity Index, race, surgery, and transfusion of red cell products on the incidence of deep venous thrombosis (DVT) and pulmonary embolism (PE).
Our study found an overall incidence of DVT and PE to be 0.4 % and 0.3 %, respectively, following foot or ankle fracture. Conservative management was found to have an increased relative risk of DVT and PE of 2.02 and 1.15, respectively. This difference persisted on performing inverse probability treatment weighting (IPTW) analysis to account for confounders. PMHVTE and requirement of blood transfusion was associated with an increased odds ratio (OR) of 3.41 and 3.217, respectively. Cases identified as Black and Asian/Pacific Islander also had an increased OR of DVT.
The results of this study demonstrate that surgical management of foot and ankle fractures is associated with a lower relative risk of VTE compared to medical management. PMHVTE and transfusion of red cell products increase the odds of VTE following either form of intervention.</description><subject>Adult</subject><subject>Aged</subject><subject>Ankle Fractures - complications</subject><subject>Ankle Fractures - epidemiology</subject><subject>Ankle Fractures - surgery</subject><subject>Conservative Treatment - statistics & numerical data</subject><subject>Deep venous thrombosis</subject><subject>Female</subject><subject>Foot and ankle fracture</subject><subject>Foot Injuries - complications</subject><subject>Foot Injuries - epidemiology</subject><subject>Foot Injuries - surgery</subject><subject>Fractures, Closed - epidemiology</subject><subject>Fractures, Closed - surgery</subject><subject>Humans</subject><subject>Incidence</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Orthopaedics</subject><subject>Postoperative Complications - epidemiology</subject><subject>Pulmonary embolism</subject><subject>Pulmonary Embolism - epidemiology</subject><subject>Pulmonary Embolism - etiology</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Trauma</subject><subject>United States - epidemiology</subject><subject>Venous thromboembolism</subject><subject>Venous Thrombosis - epidemiology</subject><issn>0020-1383</issn><issn>1879-0267</issn><issn>1879-0267</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kctu1DAUhi0EotPCGyDkJZsMvgQnYYFUVUArVeqmXVtn7JPWg2MPtjPVPFFfEw8pLLuyZH3n9n-EfOBszRlXn7drF7ZzOqwFE-2ac95_GV6RFe-7oWFCda_JijHBGi57eUJOc94yxjsm5VtyIodWSNWxFXm6CsZZDAZpHKlF3NE9ukDLQ4rTJmaXKQRLd7OfYoB0oFh_vcsTrZDxMaOlY4zlLwXhl0c6JjBlTphpSQilAo-uPFATQ8a0h-L2WGekPGea53TvDHg6QYB7nDCUr_SchgrF8Fj3qi3BH-oW78ibEXzG98_vGbn78f324rK5vvl5dXF-3RjR8tJ0skMJfduPnRSiRmFBoVQolGIMRiVVDcvgMIgRAATaDtmmMxzBDpVHeUY-LX13Kf6eMRc9uWzQewgY56xlzVkyWbOuaLugJsWcE456l9xUM9Kc6aMivdWLIn1UpBdFtezj84R5M6H9X_TPSQW-LQDWO_cOk87GHQ1Zl9AUbaN7ecIfGS6o4g</recordid><startdate>202412</startdate><enddate>202412</enddate><creator>Kohli, Meera</creator><creator>Atodaria, Kuldeepsinh P.</creator><creator>Patel, Rajeshkumar</creator><creator>Brahmabhatt, Shyam</creator><creator>Goyal, Aakash R.</creator><creator>Raval, Neha</creator><general>Elsevier Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0009-0005-8163-2628</orcidid><orcidid>https://orcid.org/0009-0001-5132-836X</orcidid></search><sort><creationdate>202412</creationdate><title>Incidence of deep vein thrombosis and pulmonary embolism in closed foot and ankle fractures treated with conservative versus surgical management: A nationwide analysis</title><author>Kohli, Meera ; Atodaria, Kuldeepsinh P. ; Patel, Rajeshkumar ; Brahmabhatt, Shyam ; Goyal, Aakash R. ; Raval, Neha</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c241t-737e3a848f7322879da6e36e26600af636024ce992faaa2ed7e0b7c1ead9228e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Ankle Fractures - complications</topic><topic>Ankle Fractures - epidemiology</topic><topic>Ankle Fractures - surgery</topic><topic>Conservative Treatment - statistics & numerical data</topic><topic>Deep venous thrombosis</topic><topic>Female</topic><topic>Foot and ankle fracture</topic><topic>Foot Injuries - complications</topic><topic>Foot Injuries - epidemiology</topic><topic>Foot Injuries - surgery</topic><topic>Fractures, Closed - epidemiology</topic><topic>Fractures, Closed - surgery</topic><topic>Humans</topic><topic>Incidence</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Orthopaedics</topic><topic>Postoperative Complications - epidemiology</topic><topic>Pulmonary embolism</topic><topic>Pulmonary Embolism - epidemiology</topic><topic>Pulmonary Embolism - etiology</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Trauma</topic><topic>United States - epidemiology</topic><topic>Venous thromboembolism</topic><topic>Venous Thrombosis - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kohli, Meera</creatorcontrib><creatorcontrib>Atodaria, Kuldeepsinh P.</creatorcontrib><creatorcontrib>Patel, Rajeshkumar</creatorcontrib><creatorcontrib>Brahmabhatt, Shyam</creatorcontrib><creatorcontrib>Goyal, Aakash R.</creatorcontrib><creatorcontrib>Raval, Neha</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Injury</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kohli, Meera</au><au>Atodaria, Kuldeepsinh P.</au><au>Patel, Rajeshkumar</au><au>Brahmabhatt, Shyam</au><au>Goyal, Aakash R.</au><au>Raval, Neha</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Incidence of deep vein thrombosis and pulmonary embolism in closed foot and ankle fractures treated with conservative versus surgical management: A nationwide analysis</atitle><jtitle>Injury</jtitle><addtitle>Injury</addtitle><date>2024-12</date><risdate>2024</risdate><volume>55</volume><issue>12</issue><spage>111859</spage><pages>111859-</pages><artnum>111859</artnum><issn>0020-1383</issn><issn>1879-0267</issn><eissn>1879-0267</eissn><abstract>Though there is extensive research on recovery and outcomes of proximal joint fractures, such as hip and knee, there is a paucity of such research in foot and ankle fractures and a lack of uniform data on the incidence of venous thromboembolism (VTE). This is a retrospective cohort study that seeks to investigate the incidence of VTE following surgically versus conservatively treated foot and ankle fractures
This study included all adult-patient hospitalizations with International Classification of Disease 10th Revision diagnosis codes related to closed foot and ankle fractures as a primary diagnosis in the National Inpatient Sample, an administrative database part of the Healthcare Cost and Utilization Project, for a total of 209,595 cases. Multivariate binary logistic regression was performed to determine the effect of age, gender, past medical history of venous thromboembolism (PMHVTE), Charlson Comorbidity Index, race, surgery, and transfusion of red cell products on the incidence of deep venous thrombosis (DVT) and pulmonary embolism (PE).
Our study found an overall incidence of DVT and PE to be 0.4 % and 0.3 %, respectively, following foot or ankle fracture. Conservative management was found to have an increased relative risk of DVT and PE of 2.02 and 1.15, respectively. This difference persisted on performing inverse probability treatment weighting (IPTW) analysis to account for confounders. PMHVTE and requirement of blood transfusion was associated with an increased odds ratio (OR) of 3.41 and 3.217, respectively. Cases identified as Black and Asian/Pacific Islander also had an increased OR of DVT.
The results of this study demonstrate that surgical management of foot and ankle fractures is associated with a lower relative risk of VTE compared to medical management. PMHVTE and transfusion of red cell products increase the odds of VTE following either form of intervention.</abstract><cop>Netherlands</cop><pub>Elsevier Ltd</pub><pmid>39423670</pmid><doi>10.1016/j.injury.2024.111859</doi><orcidid>https://orcid.org/0009-0005-8163-2628</orcidid><orcidid>https://orcid.org/0009-0001-5132-836X</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0020-1383 |
| ispartof | Injury, 2024-12, Vol.55 (12), p.111859, Article 111859 |
| issn | 0020-1383 1879-0267 1879-0267 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_3118303859 |
| source | MEDLINE; Elsevier ScienceDirect Journals |
| subjects | Adult Aged Ankle Fractures - complications Ankle Fractures - epidemiology Ankle Fractures - surgery Conservative Treatment - statistics & numerical data Deep venous thrombosis Female Foot and ankle fracture Foot Injuries - complications Foot Injuries - epidemiology Foot Injuries - surgery Fractures, Closed - epidemiology Fractures, Closed - surgery Humans Incidence Male Middle Aged Orthopaedics Postoperative Complications - epidemiology Pulmonary embolism Pulmonary Embolism - epidemiology Pulmonary Embolism - etiology Retrospective Studies Risk Factors Trauma United States - epidemiology Venous thromboembolism Venous Thrombosis - epidemiology |
| title | Incidence of deep vein thrombosis and pulmonary embolism in closed foot and ankle fractures treated with conservative versus surgical management: A nationwide analysis |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-11T10%3A24%3A00IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Incidence%20of%20deep%20vein%20thrombosis%20and%20pulmonary%20embolism%20in%20closed%20foot%20and%20ankle%20fractures%20treated%20with%20conservative%20versus%20surgical%20management:%20A%20nationwide%20analysis&rft.jtitle=Injury&rft.au=Kohli,%20Meera&rft.date=2024-12&rft.volume=55&rft.issue=12&rft.spage=111859&rft.pages=111859-&rft.artnum=111859&rft.issn=0020-1383&rft.eissn=1879-0267&rft_id=info:doi/10.1016/j.injury.2024.111859&rft_dat=%3Cproquest_cross%3E3118303859%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=3118303859&rft_id=info:pmid/39423670&rft_els_id=S0020138324005886&rfr_iscdi=true |