THE INCIDENCE AND RISK FACTORS FOR VENOUS THROMBOEMBOLISM IN PATIENTS FOLLOWING A FEMORAL NECK FRACTURE

Abstract

Background: Venous thromboembolism (VTE) remains a significant cause of morbidity and mortality of patients following hip fracture. It is not known preoperatively which patients are at greater risk of developing VTE complications following their surgery. This study reports the incidence of VTE following neck of femur fracture, the timing of the diagnosis of VTE and any risk factors associated with VTE development.

Materials and Methods: We analysed the prospectively recorded complications of patients that presented with a neck of femur fracture. Those patients that developed VTE were compared to those with no complications and their risk factors compared.

Results: A total of 5300 patients were analysed. The incidence of VTE was 2% despite thromboprophylaxis. The significant risk factors for VTE were poor pre operative mobility (p< 0.01), those preoperatively living in their own home (p< 0.01), low mental test score (p< 0.01), high postoperative haemoglobin (p< 0.03), intertrochanteric fractures and fixation with a dynamic hip screw (p< 0.01).

Conclusions: This is the largest group of patients to be prospectively analysed for risk factors for developing VTE following surgery for neck of femur fractures. There were a number of groups that were at a significantly higher risk of developing VTE than others. Orthopaedic surgeons should be aware of these groups in the management of these vulnerable patients.