ANALYSIS OF THE PREVALENCE AND RISK FACTORS FOR VENOUS THROMBOEMBOLIC COMPLICATIONS IN PATIENTS WITH PROXIMAL FEMORAL FRACTURES

Abstract

Due to the increasing incidence of PFA fractures and the associated morbidity and disability, the treatment and rehabilitation of patients with this pathology is a global problem of modern traumatology and orthopedics. Objective. To determine the incidence of venous thromboembolic complications in the setting of proximal femoral fractures, the presence of additional risk factors, and the possibility of using the Caprini score to identify surgical patients at “extremely high risk” of venous thromboembolism (VTE). Methods. The examination and treatment results of 153 (58 men, 95 women) patients aged 23 to 94 years (average 69.95±15.83 years) with proximal femoral fracture were studied. Results. The incidence of acute venous thromboembolic complications among patients with proximal femoral fractures is 13.7 %. The vast majority (98 %) of patients in this category have additional risk factors for VTE development, in addition to femoral fracture. A Caprini score of 10 points is associated with an increase in the risk of VTE development in patients with proximal femoral fractures by 11.7 times (95 % CI [1.25–109.3]), 11 points — by 23.7 times (95 % CI [2.25–250.2]), 12 points — by 45.1 times (95 % CI [4.42–461.0]), 13 and more points — by 79 times (95 % CI [8.95– 697.4]) compared with the presence of 5–8 points. Conclusions. The Caprini score was found to identify patients at “extremely high risk” of developing VTE. The cut–off level of the Caprini score > 10 points allowed identifying patients at “extremely high risk” of thrombosis (AUROC 0.845; 95 % CI 0.769–0.922).