Journal of Orthopaedic Surgery and Research · Oct 17, 2025

The correlation between smoking and preoperative deep venous thrombosis after hip fracture in geriatric patients: a propensity score-matched study

By Tang W, Li R

PURPOSE: This study aimed to investigate the association between smoking and the incidence of preoperative deep venous thrombosis (DVT) after hip fracture in geriatric patients. METHODS: This retrospective cohort study included 1,190 geriatric patients who underwent surgery for hip fractures. Patients were categorized into smokers and non-smokers based on their smoking history. Multivariable logistic regression analyses were conducted to estimate adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for preoperative DVT, controlling for potential confounders. Propensity score matching (PSM) was employed to minimize confounding variables, including age, sex, and comorbidities. Additionally, a dose-response analysis was performed to assess the relationship between the intensity of smoking and the probability of preoperative DVT. RESULTS: The incidence of preoperative DVT was significantly higher in smokers compared to non-smokers before PSM (27.6% vs. 11.9%, p < 0.001) and after PSM (26.3% vs. 11.4%, p < 0.001). Smoking was an independent predictor of increased preoperative DVT risk, with an adjusted OR of 3.68 (95% CI 2.23-6.08, p < 0.001) after multivariable regression and 2.75 (95% CI 1.47-5.14, p < 0.001) after PSM. A dose-response relationship was observed between smoking intensity and preoperative DVT risk. CONCLUSIONS: Smoking is an independent risk factor for preoperative DVT after hip fracture in geriatric patients. Moreover, a dose-response relationship was observed, with higher smoking intensity corresponding to a greater risk of DVT.

doi.org/10.1186/s13018-025-06014-5Open accessPubMed 41107951Populations