{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T11:18:41Z","timestamp":1783423121622,"version":"3.54.6"},"reference-count":21,"publisher":"IMR Press","issue":"6","license":[{"start":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T00:00:00Z","timestamp":1781568000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Ningbo Clinical Research Center for Orthopedics, Sports Medicine & Rehabilitation","award":["2024L004"],"award-info":[{"award-number":["2024L004"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Br. J. Hosp. Med. (Lond)"],"abstract":"<jats:p>Aims\/Background: Venous thromboembolism (VTE) is a frequent complication following femoral fracture surgery. While intermittent pneumatic compression (IPC) devices serve as an effective mechanical prophylaxis, patient compliance is often suboptimal. This study aimed to investigate the effectiveness of IPC in preventing VTE after femoral fracture surgery and to analyse the key factors influencing patient compliance. Methods: This retrospective study included 213 patients with femoral fractures who underwent surgical treatment at Ningbo No.6 Hospital between December 2021 and December 2024. Based on postoperative IPC device usage records from medical charts, patients were divided into a good compliance group (n = 51) and a compliance barrier group (n = 162). Postoperative coagulation parameters [prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT), fibrinogen (FIB), and D-dimer (D-D)], VTE incidence at 5 days postoperatively, and the length of hospital stay were systematically collected and compared between the two groups. A self-designed questionnaire was used to assess factors influencing IPC compliance barriers. Results: Among the 213 included patients who underwent femoral fracture surgery, the incidence of postoperative IPC device compliance barriers was 76.06% (162\/213). At 5 days postoperatively, significant differences were observed in all coagulation parameters between the two groups. Specifically, the good compliance group had significantly higher PT, APTT, and TT levels compared with the compliance barrier group (all p &lt; 0.05). In contrast, FIB and D-D levels were significantly lower in the good compliance group (all p &lt; 0.05). Regarding clinical outcomes, the incidence of VTE in the good compliance group was 19.61%, significantly lower than the 38.27% in the compliance barrier group (p = 0.014). Furthermore, the median length of hospital stay in the good compliance group [8.00 (8.00, 17.00) days] was significantly shorter than that in the compliance barrier group [12.00 (9.00, 17.00) days] (p = 0.009). The survey results of 162 patients in the compliance barrier group showed that the main obstacles affecting IPC device application compliance were concentrated at the level of patient cognition, experience, and perception. A smaller proportion of patients had concerns about out-of-pocket costs. Healthcare-related factors and device-related factors had a relatively lower impact. Conclusion: The use of IPC after femoral fracture surgery can effectively improve the hypercoagulable state, reduce the incidence of VTE, and shorten hospitalization. However, patient compliance is generally low, primarily influenced by insufficient cognition, poor user experience, and low perceived value of treatment. It is recommended to improve compliance through systematic health education, optimizing comfort and convenience of use, strengthening healthcare follow-up and feedback, and ensuring device maintenance and configuration.<\/jats:p>","DOI":"10.31083\/bjhm54929","type":"journal-article","created":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T10:55:28Z","timestamp":1783421728000},"source":"Crossref","is-referenced-by-count":0,"title":["Assessing Effectiveness and Compliance Barriers of Intermittent Pneumatic Compression Devices in Preventing Venous Thromboembolism After Femoral Fracture Surgery"],"prefix":"10.31083","volume":"87","author":[{"given":"Lin","family":"Ma","sequence":"first","affiliation":[{"name":"Department of Emergency, Ningbo No.6 Hospital, 315040 Ningbo, Zhejiang, China"},{"name":"Ningbo Clinical Research Center for Orthopedics, Sports Medicine & Rehabilitation, 315040 Ningbo, Zhejiang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-9663-8927","authenticated-orcid":true,"given":"Jianan","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Emergency, Ningbo No.6 Hospital, 315040 Ningbo, Zhejiang, China"},{"name":"Ningbo Clinical Research Center for Orthopedics, Sports Medicine & Rehabilitation, 315040 Ningbo, Zhejiang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"16242","published-online":{"date-parts":[[2026,6,16]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","unstructured":"Wu SC, Rau CS, Kuo SCH, Chien PC, Hsieh CH. The influence of ageing on the incidence and site of trauma femoral fractures: a cross-sectional analysis. BMC Musculoskeletal Disorders. 2019; 20: 413.","DOI":"10.1186\/s12891-019-2803-x"},{"key":"ref2","doi-asserted-by":"publisher","unstructured":"Shin WC, Moon NH, Do MU, Jung SJ, Kim DH, Suh KT. Incidence and risk factors for failure of conservative treatment for valgus impacted femoral neck fractures in elderly patients with high-risk comorbidities-A bi-center retrospective observational study. Injury. 2021; 52: 3453\u20133460.","DOI":"10.1016\/j.injury.2021.08.002"},{"key":"ref3","unstructured":"Nasr AM, Mc Leod I, Sabboubeh A, Maffulli N. Conservative or surgical management of distal femoral fractures. A retrospective study with a minimum five year follow-up. Acta Orthopaedica Belgica. 2000; 66: 477\u2013483."},{"key":"ref4","doi-asserted-by":"publisher","unstructured":"Lu C, Wei X, Li L, Lan W, Wu P, Hu Q, et al. Robot-assisted PFNA surgery improves clinical outcomes in the treatment of unstable femoral intertrochanteric fractures in elderly patients compared with traditional PFNA surgery. Scientific Reports. 2025; 15: 3836.","DOI":"10.1038\/s41598-025-88229-4"},{"key":"ref5","doi-asserted-by":"publisher","unstructured":"Uzel K, Azboy \u0130, Parvizi J. Venous thromboembolism in orthopedic surgery: Global guidelines. Acta Orthopaedica et Traumatologica Turcica. 2023; 57: 192\u2013203.","DOI":"10.5152\/j.aott.2023.23074"},{"key":"ref6","doi-asserted-by":"publisher","unstructured":"Riehl JT, Embry NJ, Zeter DG, Potgieter CJ, Box MW. Incidence of venous thromboembolism in fracture below the knee with and without chemical thromboprophylaxis: a systematic review and meta-analysis. Archives of Orthopaedic and Trauma Surgery. 2024; 145: 86.","DOI":"10.1007\/s00402-024-05675-x"},{"key":"ref7","doi-asserted-by":"publisher","unstructured":"Nicolaides AN, Fareed J, Spyropoulos AC, Kakkar RHL, Antignani PL, Avgerinos E, et al. Prevention and management of venous thromboembolism. International Consensus Statement. Guidelines according to scientific evidence. International Angiology. 2024; 43: 1\u2013222.","DOI":"10.23736\/S0392-9590.23.05177-5"},{"key":"ref8","doi-asserted-by":"publisher","unstructured":"Pranata R, Deka H, Yonas E, Vania R, Tondas AE, Lukito AA, et al. The use of intermittent pneumatic compression to prevent venous thromboembolism in neurosurgical patients-A systematic review and meta-analysis. Clinical Neurology and Neurosurgery. 2020; 191: 105694.","DOI":"10.1016\/j.clineuro.2020.105694"},{"key":"ref9","doi-asserted-by":"publisher","unstructured":"Zeng M, Wu Z. An Evidenced-Based Review of the Prevention of Venous Thromboembolism in Traumatic Patients with Intermittent Pneumatic Compression Devices. Emergency Medicine International. 2023; 2023: 2116496.","DOI":"10.1155\/2023\/2116496"},{"key":"ref10","doi-asserted-by":"publisher","unstructured":"Singh V, Mishra A, Sharma D, Singal U, Islam N, Islam MJ, et al. Intermittent pneumatic compression therapy as a preventive measure for venous thromboembolism after total hip arthroplasty: A systematic review. PLoS ONE. 2025; 20: e0318954.","DOI":"10.1371\/journal.pone.0318954"},{"key":"ref11","doi-asserted-by":"publisher","unstructured":"Fan C, Jia L, Fang F, Zhang Y, Faramand A, Chong W, et al. Adjunctive Intermittent Pneumatic Compression in Hospitalized Patients Receiving Pharmacologic Prophylaxis for Venous Thromboprophylaxis: A Systematic Review and Meta-Analysis. Journal of Nursing Scholarship. 2020; 52: 397\u2013405.","DOI":"10.1111\/jnu.12566"},{"key":"ref12","doi-asserted-by":"publisher","unstructured":"Kim NY, Ryu S, Kim YH. Effects of intermittent pneumatic compression devices interventions to prevent deep vein thrombosis in surgical patients: A systematic review and meta-analysis of randomized controlled trials. PLoS ONE. 2024; 19: e0307602.","DOI":"10.1371\/journal.pone.0307602"},{"key":"ref13","doi-asserted-by":"publisher","unstructured":"Kakkos S, Kirkilesis G, Caprini JA, Geroulakos G, Nicolaides A, Stansby G, et al. Combined intermittent pneumatic leg compression and pharmacological prophylaxis for prevention of venous thromboembolism. The Cochrane Database of Systematic Reviews. 2022; 1: CD005258.","DOI":"10.1002\/14651858.CD005258.pub4"},{"key":"ref14","doi-asserted-by":"publisher","unstructured":"Li C, Xie X, Zheng HT, Gao X, Li CY. The Effect of Intermittent Pneumatic Compression Device Combined with Low-Molecular-Weight Heparin on the Prevention of Deep Vein Thrombosis in Elderly Patients after Femoral Neck Fracture Surgery. British Journal of Hospital Medicine. 2024; 85: 1\u201312.","DOI":"10.12968\/hmed.2024.0442"},{"key":"ref15","doi-asserted-by":"publisher","unstructured":"Duval C, Sirois C, Savoie-White FH, Tardif PA, B\u00e9rub\u00e9 M, Turgeon AF, et al. Effect of Intermittent Pneumatic Compression in Addition to Pharmacologic Prophylaxis for Thromboprophylaxis in Hospitalized Adult Patients: A Systematic Review and Meta-Analysis. Critical Care Explorations. 2022; 4: e0769.","DOI":"10.1097\/CCE.0000000000000769"},{"key":"ref16","doi-asserted-by":"publisher","unstructured":"Wang Y, Huang D, Wang M, Liang Z. Can Intermittent Pneumatic Compression Reduce the Incidence of Venous Thrombosis in Critically Ill Patients: A Systematic Review and Meta-Analysis. Clinical and Applied Thrombosis\/Hemostasis. 2020; 26: 1076029620913942.","DOI":"10.1177\/1076029620913942"},{"key":"ref17","doi-asserted-by":"publisher","unstructured":"Morris RJ, Roberts CH. Haematological Effects of Intermittent Pneumatic Compression for Deep Vein Thrombosis Prophylaxis. Thrombosis and Haemostasis. 2020; 120: 912\u2013923.","DOI":"10.1055\/s-0040-1710016"},{"key":"ref18","doi-asserted-by":"publisher","unstructured":"Rifkind JM, Nagababu E, Dobrosielski DA, Salgado MT, Lima M, Ouyang P, et al. The effect of intermittent pneumatic compression of legs on the levels of nitric oxide related species in blood and on arterial function in the arm. Nitric Oxide. 2014; 40: 117\u2013122.","DOI":"10.1016\/j.niox.2014.06.007"},{"key":"ref19","doi-asserted-by":"publisher","unstructured":"Chen AH, Frangos SG, Kilaru S, Sumpio BE. Intermittent pneumatic compression devices\u2014physiological mechanisms of action. European Journal of Vascular and Endovascular Surgery. 2001; 21: 383\u2013392.","DOI":"10.1053\/ejvs.2001.1348"},{"key":"ref20","doi-asserted-by":"publisher","unstructured":"Reinhard M, Flynn KE, Palatnik A. Patient-reported barriers and facilitators for intermittent pneumatic compression device use on the antepartum unit. The Journal of Maternal-Fetal & Neonatal Medicine. 2022; 35: 10388\u201310394.","DOI":"10.1080\/14767058.2022.2128655"},{"key":"ref21","doi-asserted-by":"publisher","unstructured":"Greenall R, Davis RE. Intermittent pneumatic compression for venous thromboembolism prevention: a systematic review on factors affecting adherence. BMJ Open. 2020; 10: e037036.","DOI":"10.1136\/bmjopen-2020-037036"}],"container-title":["British Journal of Hospital Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.imrpress.com\/journal\/BJHM\/87\/6\/10.31083\/BJHM54929","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T10:59:03Z","timestamp":1783421943000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.imrpress.com\/journal\/BJHM\/87\/6\/10.31083\/BJHM54929"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,16]]},"references-count":21,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026]]}},"alternative-id":["S1750-8460(26)03002-0"],"URL":"https:\/\/doi.org\/10.31083\/bjhm54929","relation":{},"ISSN":["1750-8460","1759-7390"],"issn-type":[{"value":"1750-8460","type":"print"},{"value":"1759-7390","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,16]]},"article-number":"54929"}}