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Venous thromboembolism and mortality after hip fracture surgery: the ESCORTE study 1,2
Author(s) -
ROSENCHER N.,
VIELPEAU C.,
EMMERICH J.,
FAGNANI F.,
SAMAMA C. M.
Publication year - 2005
Publication title -
journal of thrombosis and haemostasis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.947
H-Index - 178
eISSN - 1538-7836
pISSN - 1538-7933
DOI - 10.1111/j.1538-7836.2005.01545.x
Subject(s) - medicine , pulmonary embolism , hip fracture , deep vein , surgery , epidemiology , incidence (geometry) , mortality rate , thrombosis , population , venous thrombosis , observational study , cohort study , osteoporosis , physics , environmental health , optics
Summary. Background: Recent changes in the management of hip fracture surgery patients may have modified the epidemiology of postoperative complications. Objectives: We performed an observational study of a cohort of patients undergoing hip fracture surgery to update the epidemiological data on this population. The primary study outcome was the incidence of confirmed symptomatic venous thromboembolism (VTE) [defined as deep vein thrombosis, pulmonary embolism (PE), or both] at 3 months. Overall mortality at 1, 3 and 6 months was also evaluated. Patients/methods: Consecutive patients aged at least 18 years hospitalized in French public or private hospitals (531 centers) undergoing hip fracture surgery were recruited prospectively during 2 months in 2002 and a follow‐up at 6 months. Predictive factors for VTE at 3 months and for death at 6 months were also analyzed. Results: Data from 6860 (97.3%) of the 7019 recruited patients were included in the analysis. The median age was 82 years. Low molecular weight heparins were administered perioperatively in 97.6% of patients; 69.5% received this treatment for at least 4 weeks. The actuarial rate of confirmed symptomatic VTE at 3 months was 1.34% (85 events, 95% CI: 1.04–1.64). There were 16 PEs (actuarial rate: 0.25%), three of which were fatal. Overall, 1006 (14.7%) patients were dead at 6 months. Cardiovascular disease was the most frequent cause of death (270 patients; 26.8%). Conclusions: The current rate of postoperative VTE is low, but overall mortality remains high. Indeed, hip fracture patients belong to a vulnerable group of old people with comorbid diseases and a high risk of postoperative morbidity and mortality. An interdisciplinary approach could be the challenge to improve short and long‐term outcome.