Incidence of deep vein thrombosis in patients with pelvic and acetabulum fractures requiring operative intervention in Hospital Universiti Sains Malaysia : is preoperative screening with doppler ultrasound necessary?
Introduction Pelvic and acetabulum fractures commonly occur due to high impact injury putting patients at higher risk of developing thromboembolic diseases such as deep vein thrombosis and pulmonary embolism. This study was performed to determine the incidence of lower extremity deep vein thromb...
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| Format: | Thesis |
| Language: | English |
| Published: |
2021
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| Subjects: | |
| Online Access: | http://eprints.usm.my/57069/1/DR%20YOLANDA%20BONIFACE%20DEYOI-24%20pages.pdf |
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| Summary: | Introduction
Pelvic and acetabulum fractures commonly occur due to high impact injury putting patients at
higher risk of developing thromboembolic diseases such as deep vein thrombosis and
pulmonary embolism. This study was performed to determine the incidence of lower extremity
deep vein thrombosis in patients with pelvic and acetabulum fractures to determine the
importance of preoperative screening with Doppler ultrasound prior to surgical intervention.
Materials and methods
This was a retrospective study involving 78 patients admitted to Hospital Universiti Sains
Malaysia with pelvic and acetabulum fractures requiring surgical intervention from January
2015 till December 2019. All patients planned for surgical intervention were screened
preoperatively with Doppler Ultrasound to detect for lower limb DVT. These were compared
with incidence of lower limb DVT post operatively. Descriptive statistical analysis was
performed using IBM SPSS Statistics Version 24.
Results
There were 78 patients included in this study consisting of 30.8% females and 69.2% male
patients. Preoperative screening with Doppler ultrasound showed 3 (3.8%) patients were
diagnosed with lower limb DVT whereas 1 (1.3%) was symptomatic and diagnosed with PE.
Postoperatively, 1 patient developed DVT and 1 patient developed PE. Both of these patients
were negative for DVT preoperatively.
Conclusion
The incidence of VTE in patients with pelvic and acetabulum fractures in our centre based on
preoperative screening is low but is significantly important to prevent further morbidity and
mortality. However, negative preoperative screening cannot safely rule out patients from
developing VTE postoperatively. Despite initiation of thromboprophylaxis in trauma patients,
we cannot prevent the incidence of venous thromboembolic diseases. We recommend
preoperative screening with Doppler ultrasound prior to operative intervention to detect DVT
especially in asymptomatic patients with pelvic and acetabulum fractures to be included in our
Malaysian Clinical Practice Guidelines for management of DVT. |
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