Incidence and Risk Factors of Venous Thromboembolism Following Hip Fracture: A Case-Control Study at Sisaket Hospital

Abstract

          This study aimed to determine the incidence and associated risk factors of venous thromboembolism (VTE) in patients with hip fractures treated at Sisaket Hospital. VTE, including deep vein thrombosis (DVT) and pulmonary embolism (PE), is a serious postoperative complication, especially in the elderly. Previous international studies have reported VTE incidence rates of 40–70% following hip surgery, but data within Thailand, particularly in regional hospitals, remains limited.        

         This retrospective descriptive and analytical case-control study was conducted using medical records of patients admitted on March 2015. A total of 2,781 patients were included. Patients who developed VTE (n=12) were compared with matched controls (n=108) to identify statistically significant risk factors.

The overall incidence of VTE was 0.43%, comprising 0.25% DVT and 0.18% PE. Most patients in the VTE group were elderly females with intertrochanteric hip fractures, had comorbidities such as anemia or chronic kidney disease (CKD), and experienced prolonged hospital stays. Univariable and multivariable logistic regression analyses revealed three statistically significant risk factors for VTE: Intertrochanteric fracture location (Adjusted OR = 5.95, p = 0.046), Longer hospital stay duration (Adjusted OR = 1.11 per day, p = 0.024)

Although the incidence of VTE in this population is relatively low compared to Western studies, patients with intertrochanteric fractures, multiple comorbidities, and prolonged immobility are at higher risk. The findings emphasize the need for proactive risk assessment, early mobilization, and appropriate prophylactic measures, tailored to the local healthcare context in regional  Thai hospitals.