Risk factors for secondary venous thromboembolism in elderly patients with severe trauma
Objective To investigate the risk factors associated with venous thromboembolism(VTE)in elderly patients with severe trauma.Methods A retrospective analysis was conducted on the clinical data of elderly patients with severe trauma admitted to the Emergency Intensive Care Unit(EICU)of the Second Affiliated Hospi-tal,Zhejiang University School of Medicine,from Feb.2016 to Dec.2020.Data collected included gender,age,BMI,underlying diseases,injury information,injury assessments,vital signs on admission,laboratory test results,treatment measures,incidence of venous thrombosis,and clinical outcomes.Patients were divided into VTE group(111 cases)and non-VTE group(260 cases)based on the occurrence of VTE.Univariate and multivariate logistic regression analyses were used to identify risk factors for VTE in these patients.Results Among the 371 elderly pa-tients with severe trauma,254 were male(68.5%)and 117 were female(31.5%),with the age ranging from 65 to 96 years and 72.4 years on average.Univariate logistic regression analysis revealed significant differences between the VTE and non-VTE groups in BMI(kg/m2,23.12±3.39 vs.22.19±3.26),proportion of head and neck injuries(73.0%vs.85.4%),Caprini score[11(9,15)vs.10(8,13)],hemoglobin[g/L,87.0(81.0,117.0)vs.107.5(88.0,126.0)],prothrombin time[s,14.8(13.7,16.2)vs.14.3(13.4,15.5)],INR[1.17(1.06,1.30)vs.1.12(1.04,1.24)],red blood cell transfusion rate(44.1%vs.27.7%),use of prophylactic anticoagulation(25.2%vs.40.0%),and incidence of acute traumatic coagulopathy(41.4%vs.30.8%)(all P<0.05).Multi-variate logistic regression analysis identified higher BMI(OR=1.092,95%CI:1.007-1.184,P=0.034),higher Ca-prini score(OR=1.085,95%CI:1.005-1.171,P=0.038),and lower rate of prophylactic anticoagulation(OR=1.959,95%CI:1.053-3.645,P=0.034)as independent risk factors for VTE in elderly patients with severe trau-ma.Conclusion The development of VTE in elderly patients with severe trauma is closely associated with high BMI,high Caprini scores,and low utilization of prophylactic anticoagulants.
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