Abstract
A prospective study involving 94 unprophylaxed. consecutive patients was performed to determine the true incidence. site and risk-factors of deep-vein thrombosis (DVT) following surgery on the hip. Surgical procedures mainly consisted of repair of hip fractures (54 patients). and total hip arthroplasty (27 patients). Most patients were in the sixth to eighth decade of Iife ranging in age from 17 to 92 years. Male to female ratio was 25: 69. Diagnosis of DVT was made on the basis of radiological signs. Ascending venography was performed on the operated on legs of all patients between the fifth and tenth days postoperatively according to the technique of Rabinov and Paulin. In all 17 DVTs were diagnosed giving an overalf incidence of 18.1%. Of these 5 (5.3%) were in femoral, 5 (5.3%) werein the calf, and 7 (7.8%) were in the calf and femoral veins. Only 11 (64.7%) of these patients had clinical findings suggesting DVT. The incidence of DVT was significantly high in the female patients, and in the 70 and over age group (23.2% and 30.2% respectively). Hip fracture surgery was shown to carry a high risk of postoperative DVT in comparison with elective hip surgery (25.5% and 10.0% respectively). The relatively low incidence of postoperative DVT in Turkish population suggests that pharmacologic manipulation to prevent DVT is necessary only for high-risk patients who carry the underlined risk-factors in this country.
Özet
Kalça cerrahisinden sonra ortaya çıkan derin-ven trombozu (DVT) nun gerçek insidansının, yerini ve faktörlerini belirlemek amacı ile kalça cerrahisi uygulanan 94 hastaya ipsilateral asendan venografi uygulandı. 17(%18.1) vakada DVT saptandı. DVT insidansının kadın hastalarda, 70 yaş üstündeki grupta ve kalça kırığı nedeni ile cerrahi uygulananlarda daha yüksek olduğu belirlendi. Postoperatif DVT nun hastalarımızda batı toplumlarında bildirilen oranlardan daha az olması nedeni ile profilaktik antikoagulasyonunun çalışmamızda belirlenen risk faktörlerini taşıyan hastalarda uygulanması gerektiği sonucuna varıldı.