title: Incidence of Preoperative Deep Vein Thrombosis in Calcaneal Fractures.
abstract: OBJECTIVE
  This study examined the incidence and risk factors of preoperative deep vein thrombosis (DVT) in patients presenting to an outpatient setting with an isolated calcaneal fracture.
  
  
  METHODS
  Retrospective chart review.
  
  
  METHODS
  All patients included in the study presented to the treating surgeon at a Level I trauma center with isolated calcaneal fractures as an outpatient between 2005 and 2013.
  
  
  METHODS
  These patients were either referred from outside hospitals, had been evaluated in the emergency department initially and presented for definitive care, or presented initially to the outpatient clinic. Patients included were over the age of 18, had a preoperative duplex ultrasonography of bilateral lower extremities per the treating surgeon's protocol, and had at minimum 6 weeks follow-up. Patients were excluded if they were a polytrauma, had a documented hypercoagulable state, or were on baseline pharmacologic anticoagulation for another condition. All patients had a preoperative duplex ultrasound of both lower extremities to evaluate for DVT at least 7 days after injury.
  
  
  METHODS
  Patients found to have a preoperative DVT were compared with those who did not have preoperative DVT for possible risk factors.
  
  
  RESULTS
  One hundred fifty-nine patients qualified for our study and of these, 19 (12%) were found to have a DVT preoperatively, almost all of which were in distal veins. All risk factors, including age, sex, and body mass index were analyzed as continuous variables. Older age was found to be a risk factor for DVT (P = 0.009, Odds Ratio = 1.06, 95% CI, 1.01-1.11). All other predictor variables, including body mass index (P = 0.05) and sex (P = 0.08), were not statistically significant predictors in our sample.
  
  
  CONCLUSIONS
  The incidence of preoperative DVT found here is almost 2 times as high as any previously published examination of lower extremity injuries. Physicians should be aware of this increase so they may counsel patients about the risks of DVTs and the likelihood of any sequelae from developing a DVT that may affect a patient's recovery.
  
  
  METHODS
  Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
authors.affiliation: *Department of Orthopaedic Surgery, University of California Los Angeles, Santa Monica, CA; †Department of Orthopaedic Surgery, Cedars-Sinai, Los Angeles, CA; ‡University of Washington Seattle, WA; and §Harborview Medical Center, University of Washington Seattle, WA.
authors.forename: Joan R
authors.initials: JR
authors.lastname: Williams
authors.forename: Milton T M
authors.initials: MT
authors.lastname: Little
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Kramer
authors.forename: Stephen K
authors.initials: SK
authors.lastname: Benirschke
mesh_terms: D017677:Age Distribution; D000368:Aged; D000556:Ambulatory Surgical Procedures / Q000009:adverse effects / Q000379:methods; D002111:Calcaneus / Q000293:injuries*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D017102:Fracture Healing / Q000502:physiology; D050723:Fractures, Bone / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D015994:Incidence; D007430:Intraoperative Care / Q000379:methods*; D016015:Logistic Models; D035002:Lower Extremity; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012189:Retrospective Studies; D018570:Risk Assessment; D017678:Sex Distribution; D016896:Treatment Outcome; D018616:Ultrasonography, Doppler, Duplex / Q000379:methods*; D020246:Venous Thrombosis / Q000175:diagnosis / Q000453:epidemiology*; D055815:Young Adult