Objective To investigate the influencing factors for postoperative deep vein thrombosis in elderly patients with inguinal hernia.
Methods The retrospective case‑control study was conducted. The clinical data of 352 elderly patients with inguinal hernia who were admitted to the Affiliated Hospital of Jining Medical College from March 2018 to March 2021 were collected. There were 325 males and 27 females, aged (72±3)years. Observation indicators: (1) treatment and follow‑up; (2) analysis of influencing factors for postoperative deep vein thrombosis. Follow‑up was conducted using outpatient examination and telephone interview to detect occurrence of deep vein thrombosis in patients up to September 2021. Measurement data with normal distribution were represented as Mean±SD, and comparison between groups was conducted using the t test. Count data were described as absolute numbers, and comparison between groups was conducted using the chi‑square test. The univariate analysis was conducted using the corresponding statistical methods based on data type. The Logistic regression model was used for multivariate analysis.
Results (1) Treatment and follow‑up. Of the 352 inguinal hernia patients, there were 18 cases with irreducible hernia and 334 cases with reducible hernia. All the 352 patients underwent laparoscopic hernio-rrhaphy successfully, including 95 cases with totally extraperitoneal prosthetic, 257 cases with transabdominal preperitoneal prosthesis. The operation time and volume of intraoperative blood loss of the 352 patients were (70±7)minutes and (8.0±1.5)mL, respectively. There were 39 cases with intraoperative blood transfusion and 313 cases without intraoperative blood transfusion, 167 cases with common patch, 185 cases with light patch. The compression time of operative area, time to first out‑of‑bed activities, duration of postoperative hospital stay of the 352 patients were (19.7±2.9)hours, (5.6±1.8)hours, (3.0±1.9)days, respectively. All the 352 patients were followed up for 6 months after operation. During the follow-up, there were 7 patients with deep vein thrombosis. (2) Analysis of influencing factors for postoperative deep vein thrombosis. Results of univariate analysis showed that age, body mass index, smoking history, alcoholism history, hypertension, chronic obstructive pulmonary disease, coronary heart disease, cerebrovascular disease, varicose veins, intraoperative blood transfusion, time to postoperative first out‑of‑bed activities, duration of postoperative hospital stay were related factors for postoperative deep vein thrombosis in elderly patients with inguinal hernia (t=2.19, 2.06, χ²=9.86, 9.02, 7.90, 14.36, 17.12, 36.25, 28.27, 7.32, t=3.30, 3.04, P<0.05). Results of multivariate analysis showed that age, hypertension, chronic obstruc-tive pulmonary disease, coronary heart disease, cerebrovascular disease, varicose veins, intraopera-tive blood transfusion, time to postoperative first out‑of‑bed activities, duration of postoperative hospital stay were independent influencing factors for postoperative deep vein thrombosis in elderly patients with inguinal hernia (odds ratio=4.32, 5.95, 6.44, 15.85, 9.63, 7.61, 9.88, 7.27, 7.96, 95% confidence intervals as 0.92‒8.72, 4.45‒12.74, 1.74‒19.46, 3.97‒36.84, 4.95‒16.26, 2.65‒18.03, 3.50‒21.47, 1.48‒16.37, 2.08‒14.73, P<0.05).
Conclusion Age, hypertension, chronic obstructive pulmonary disease, coronary heart disease, cerebrovascular disease, varicose veins, intraoperative blood transfusion, time to postoperative first out‑of‑bed activities, duration of postoperative hospital stay are independent influencing factors for postoperative deep vein thrombosis in elderly patients with inguinal hernia.
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