DOS 2017

DOS Kongressen 2017 ·

Excess Risk of Venous Thromboembolism in Hip Frac-

ture Patients and the Prognostic Impact of Comorbid-

ity

Alma B. Pedersen, Vera Ehrenstein, Szimonetta Szépligeti, Henrik T. Sørensen

Department of Clinical Epidemiolgy, Aarhus Universityhospital

Background:

Hip fracture patients are at increased risk of venous thrombo-

embolism (VTE). The magnitude or duration of potential excess VTE risk among

hip fracture patients and the duration of this potential risk have not yet been

studied.

Purpose / Aim of Study:

We examined the risk of VTE in hip fracture patients

and a comparison cohort from the general population over a 20-year period,

both overall and by comorbidity level.

Materials and Methods:

Nationwide cohort study based on prospectively col-

lected data from Danish health registries. We identified patients who were aged

>55 years with incident hip fracture (n= 110,563) between 1995 and 2015.

We sampled a comparison cohort without hip fracture from the general popula-

tion (n= 552,774).

Findings / Results:

Among hip fracture patients, the cumulative incidences of

VTE were 0.73% within 30 days and 0.83% within 31-365 days. Correspond-

ing cumulative incidences in the general population were 0.05% and 0.43%,

respectively. Adjusted hazard ratios (HRs) of VTE among hip fracture patients

were 17.29 [95% CI: 14.74-20.28] during the first 30 days and 2.13 (95%

CI: 1.95 20.28] during the first 30 days and 2.13 (95% CI: 1.95-2.32) during

31-365 days compared with the general population. The relative risks of VTE

also were 1.03 (95% CI: 0.96-1.11) and 1.11 (95% CI: 1.00-1.23) during 1-5

years and 6-10 years following hip fracture. During the first 30 days and 31-

365 days following hip fracture, 14%/28% of VTE rates and 5%/4% of VTE

rates were attributable to the interaction between hip fracture and severe/very

severe comorbidity, respectively.

Conclusions:

Hip fracture patients were at increased excess risk of VTE up

to one year following their fracture.The interaction between hip fracture and

comorbidity could explain up to 23% of VTE risk within 30 days following hip

fracture in patients with severe and very severe comorbidity.

No conflicts of interest reported

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