Risk factors analysis for acute lower deep venous thrombosis in multiple injury patients / 上海交通大学学报（医学版）

ABSTRACT

Objective • To explore the incidence and analyze the risk factors of acute lower deep venous thrombosis (ALDVT) in multiple injury patients. Methods • A total of 175 multiple injury patients in trauma emergency center of The Sixth People's Hospital, Shanghai Jiao Tong University, from Jan. to Jun. in 2017 were chosen, and their clinical data were collected. The ALDVT group and the non-ALDVT group were differentiated according to the results of ultrasound, and the incidence of ALDVT was calculated. Univariate analysis and multivariate Logistic regression analysis were used to investigate the correlations between the occurrance of ALDVT and the factors, including demographic characteristics, vital signs and hematological parameters. Results • Fifty-six patients (32%) developed ALDVT in 175 multiple injury patients. Univariate analysis showed that there were statistically significant differences in the numbers of multiple injury patients with upper limb fracture, lower limb fracture, spinal injury, pelvic fracture, chest and abdomen injury, higher injury severity score (ISS) (≥ 25 scores), or higher glucose (≥ 10 mmol/L) between two groups (all P<0.05). In the coagulation parameters, compared with the non-ALDVT group, the levels of D-dimer and fibrinogen degradation products in the ALDVT group were significantly elevated (both P=0.001). Multivariate Logistic regression analysis showed that the level of glucose (≥ 10 mmol/L) (P=0.009), ISS (≥ 25 scores) (P=0.024), multiple injury with spinal injury (P=0.048), and multiple injury with pelvic fracture (P=0.029) were the independent risk factors of the ALDVT patients. Conclusion • There is a high occurrence of ALDVT in multiple injury patients. The level of glucose, ISS, multiple injury with spinal injury, and multiple injury with pelvic fracture have important predictive significance for the diagnosis of ALDVT.