Predictors of Deep Vein Thrombosis and Hypercoagulability Profiles in Major Orthopedic Surgery Patients

International Journal of Medicine and Medical Sciences | Vol. 11, No. 12, December 2021 | pp. 89–96

DOI: 10.46882/2021/IJMMS/110089

Original Research Article

Predictors of Deep Vein Thrombosis and Hypercoagulability Profiles in Major Orthopedic Surgery Patients

Ibrahim K. Diallo¹, Victoria N. Eke², Jean-Baptiste M. Diop¹*

¹Department of Haematology, Faculté de Médecine, de Pharmacie et d'Odontologie, Université Cheikh Anta Diop, Dakar, Senegal.

²Department of Hematology and Blood Transfusion, College of Medicine, University of Lagos, Idi-Araba, Lagos, Nigeria.

Abstract:

Deep vein thrombosis (DVT) is a serious complication following major orthopedic procedures, requiring precise risk assessment and effective prophylaxis. This prospective cohort study evaluated hypercoagulability profiles and clinical predictors of DVT in patients undergoing major orthopedic surgery (total hip or knee arthroplasty and fixation of lower limb fractures). We evaluated 130 adult patients who did not receive routine chemical thromboprophylaxis prior to surgery due to clinical contraindications. Duplex ultrasonography screening was performed on postoperative days 3 and 7 to detect asymptomatic or symptomatic DVT. Coagulation parameters, including plasma fibrinogen, antithrombin III, and D-dimer, were measured preoperatively and postoperatively. The overall incidence of confirmed DVT within 7 days post-surgery was 16.9% (22/130), with 72.7% of cases being asymptomatic. Patients who developed DVT had significantly higher mean postoperative day 3 D-dimer levels (2.85 ± 0.64 μg/mL) compared to those without DVT (1.42 ± 0.35 μg/mL, p < 0.001). Multivariate logistic regression modeling demonstrated that an age ≥ 60 years (OR = 3.4, 95% CI = 1.5–7.8, p < 0.01), operative duration > 120 minutes (OR = 2.8, 95% CI = 1.2–6.4, p < 0.05), and a body mass index ≥ 30 kg/m² (OR = 2.5, p < 0.05) were independent predictors of DVT development. Major orthopedic surgeries are associated with a high incidence of early postoperative DVT, particularly in older or obese patients and during prolonged surgeries. Routine duplex ultrasound surveillance and timely initiation of thromboprophylaxis are critical.

Keywords: Deep Vein Thrombosis, Orthopedic Surgery, Hypercoagulability, D-Dimer, Risk Factors, Thromboprophylaxis

Manuscript Timeline: Received: August 28, 2021; Revised: October 05, 2021; Accepted: November 02, 2021; Published: December 15, 2021.

Citation: Diallo IK, Eke VN, Diop JBM. Predictors of Deep Vein Thrombosis and Hypercoagulability Profiles in Major Orthopedic Surgery Patients. International Journal of Medicine and Medical Sciences, 2021, 11(12): 89–96. DOI: 10.46882/2021/IJMMS/110089

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