10ASSESSMENT FOR POSTOPERATIVE DVT IN OLDER PEOPLE WITH HIP FRACTURES

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Abstract

Background: Deep vein thrombosis (DVT) is a common postoperative complication in patients who have sustained a fractured neck of femur. DVTs are difficult to differentiate clinically from postoperative leg swelling. We were interested to address what proportion of patients who underwent Doppler ultrasound scanning in this setting had a DVT.

Sampling Methods: We conducted a retrospective review of patients who underwent Doppler ultrasound scanning following hip fracture repair. Clinical records of all patients (204) who were admitted with hip fracture over a five month period were screened. Detailed information was collected for those who had a Doppler ultrasound scan following surgery using clinical notes and electronic patient records.

Results: 30 patients (14.7%) underwent Doppler ultrasound scan. 5 out of 30 had a DVT. Those who had a DVT were scanned an average of 22 days post operation. The majority were diagnosed in rehabilitation. In the acute setting, zero (0/11) ultrasound scans ordered by orthopaedic or Medicine of the Elderly doctors led to a diagnosis of DVT.

Conclusions: Our survey demonstrated that swelling in an operated leg in this group is sometimes attributable to DVT, although more often is due to other causes, such as post-operative oedema. The yield from ultrasound scanning was low. We suggest that in cases of peri-operative swelling of the operated limb, that a second opinion of the operating orthopaedic team should be sought before ordering a Doppler scan.

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