Triaging with deep vein thrombosis ultrasonography after lower extremity orthopedic surgery
Hee Joong Lim1 , Sheen-Woo Lee1 , Ji Young Jeon1, Yu Mi Jeong1, Beom Gu Lee2, Jae-Ang Sim2
1Department of Radiology, Gachon University Medical Center, Gachon University, Incheon, Korea
2Department of Orthopedic Surgery, Gachon University Medical Center, Incheon, Korea
3Radiology, Catholic Medical College, Enpyeong St. Mary's Hospital., Seoul, Korea
Corresponding Author: Sheen-Woo Lee ,Tel: 032-460-3060 , Fax: 032-460-3065, Email: leesw1@gmail.com
Received: October 29, 2020;  Accepted: January 12, 2021.  Published online: January 12, 2021.
ABSTRACT
Purpose:
To stratify risk factors and vein levels for postoperative deep vein thrombosis (DVT) after lower extremity orthopedic surgery.
Methods:
Ninety-nine patients who underwent Doppler ultrasound after lower extremity orthopedic surgery were enrolled. Medical records were reviewed for the duration of anesthesia, type of surgery, body weight, height, and cardiovascular risk factors, including history of smoking, diabetes mellitus or hypertension, blood pressure, and total cholesterol and high-density lipoprotein (HDL) cholesterol levels, and the DVT treatment. Ultrasound diagnosis of DVT was made according to routine protocol. Relationships between selected factors and the presence of DVT were assessed using univariate and multivariate regression analyses.
Results:
Thirty-two patients were found to have calf DVT. The mean age, weight, and height of non-DVT and postoperative DVT patients were 55.1 vs. 65.4 years, 70.5 vs. 61.2 kg, and 163.3 vs. 157.0 cm, respectively. Total cholesterol/HDL in non-DVT and DVT were 70.6/20.7 mg/dL vs. 90.8/26.0 mg/dL. Systolic and diastolic blood pressure in non-DVT and DVT patients were 133.6/80.2 vs, 132.2/78.1 mm/Hg. Mean duration of anesthesia was 173.9 vs. 199.9 min, and operative time was 136.4 vs. 161.0 min. Older age and lower body weight were found to be significantly associated with postoperative DVT. There were no significant differences in other data between the groups. The patients with DVT on US received antithrombotic treatment. None of them had distant thromboembolism.
Conclusion:
After lower extremity orthopedic surgery, calf veins in elderly patients with low body weight are susceptible to thrombosis; they would most likely benefit from postoperative ultrasound.
Keywords: Deep vein thrombosis; Ultrasound; Postoperative; Risk factor; Orthopedic
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