Calf vein thrombosis ups 30-day death risk in older adults with hip fractures

Among older adults suffering from hip fractures, calf deep vein thrombosis (DVT) appears to significantly aggravate the risk of 30-day all-cause mortality, a recent study has found. However, no such effect exists for the 90-day death risk.

A group of researchers conducted a retrospective cohort study of 564 consecutive patients, of whom 86 (15.2 percent) had ultrasound-confirmed calf DVT, 66 had muscular DVT, and 20 had axial DVT. The remaining participants were designated as controls.

The resulting 30-day all-cause mortality was 2.5 percent, which increased to 6.0 percent by 90 days. Multivariate Cox regression analysis revealed that the presence of calf DVT more than tripled the risk of 30-day all-cause mortality as compared with controls (hazard ratio [HR], 3.21, 95 percent confidence interval [CI], 1.05–9.84; p=0.04).

Such an effect was driven by muscular DVT, which aggravated 30-day death risk by nearly four times (HR, 3.95, 95 percent CI, 1.18–13.15; p=0.03). No such effect was reported for axial DVT (HR, 1.79, 95 percent CI, 0.21–15.02; p=0.59).

Of note, the impact of calf DVT was attenuated by 90 days, such that the corresponding excess risk estimate dropped to below 60 percent and was no longer statistically significant (HR, 1.59, 95 percent CI, 0.69–3.71; p=0.28).

“Calf DVT should receive more attention from clinicians, especially in the initial 30 days following an acute thrombotic event,” the researchers said. Future prospective analyses with larger study samples are needed to validate the present findings.