Vol.:(0123456789) 1 3 European Journal of Trauma and Emergency Surgery https://doi.org/10.1007/s00068-018-1059-8 ORIGINAL ARTICLE High prevalence of deep vein thrombosis in elderly hip fracture patients with delayed hospital admission Francisco Bengoa 1  · Gerardo Vicencio 2  · Daniel Schweitzer 1  · Maria Jesus Lira 1  · Tomás Zamora 1  · Ianiv Klaber 1 Received: 10 August 2018 / Accepted: 4 December 2018 © Springer-Verlag GmbH Germany, part of Springer Nature 2018 Abstract Purpose Deep vein thrombosis (DVT) is a common complication in hip fracture patients, associated with significant mor- bidity and mortality. Research has focused on postoperative DVT, with scant reports on preoperative prevalence. The aim of this study was to describe the prevalence of preoperative DVT in patients accessing medical care ≥ 48 h after a hip fracture. Methods We included elderly patients admitted ≥ 48 h after sustaining a hip fracture, between September 2015 and October 2017. Patients with a previous episode of DVT, undergoing anticoagulation therapy, with pathologic fractures or undergoing cancer treatment were excluded. Of 273 patients, 59 were admitted at least 48 h after the fracture. DVT screening by Doppler ultrasound of both lower extremities was carried upon hospital admission. We recorded age, sex, Charlson comorbidity index and ASA score, fracture type, time since injury, time from admission to surgery and total length of hospital stay. Results We studied 41 patients, 79 (± 10.34) years old. The delay from injury to admission was 120 h (48–696 h). Seven patients (17.1%) had a DVT upon admission. There were no significant differences between patients with and without DVT, regarding time from admission to surgery or the total length of the hospital stay. Conclusions The prevalence of DVT in patients admitted ≥ 48 h after a hip fracture was 17.1%. The diagnosis and manage- ment of DVT did not increase time to surgery or hospital stay. Our results suggest routine screening for DVT in patients consulting emergency services ≥ 48 h after injury. Keywords Thromboprophylaxis · Hip fracture · Deep vein thrombosis · Orthogeriatrics Background Hip fractures are frequent in elderly adults [1]. Deep vein thrombosis (DVT) is a common complication in these patients and represents one of the main causes of morbid- ity and mortality. The prevalence of preoperative DVT can reach up to 62% in hip fracture patients, depending on the delay to surgery, if prophylaxis was used, ethnicity, comor- bidities, and other factors [2, 3]. Delays in accessing emergency care are associated with longer preoperative immobilisation, one of the major risk factors for thromboembolic disease [4]. The few available reports on the matter show that up to 55% of patients seek- ing medical care ≥ 48 h after injury develop DVT; however, these studies are based on very small sample sizes [5, 6]. Due to the scarce available data on preoperative DVT in patients with hip fracture and delayed access to medical care, the aim of this study was to describe the prevalence of DVT in patients admitted ≥ 48 h after sustaining a hip fracture. Methods This study was approved by the institutional review board (No. 170628010). We carried out a cross-sectional study of patients presenting with a hip fracture at the emergency department of a university hospital ≥ 48 h after injury, between September 2015 and October 2017. We recruited among all patients admitted with a diagnosis of hip fracture to our health centre, through our emergency department. We included patients with femoral neck, inter- trochanteric and subtrochanteric fractures. Among these, we * Ianiv Klaber iklaber@med.puc.cl 1 Department of Orthopaedic Surgery, School of Medicine, Pontificia Universidad Catolica de Chile, Diagonal Paraguay 362, Tercer Piso, Santiago, Chile 2 School of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile