Risk factors for deep vein thrombosis following total hip arthroplasty in elderly patients with femoral neck fractures during winter

Abstract

Objective To investigate the risk factors for deep vein thrombosis (DVT) following total hip arthroplasty in elderly patients with femoral neck fractures during the winter. Methods A total of 162 patients who underwent total hip arthroplasty were categorized based on the development of DVT within 7 days postoperatively: 28 patients formed the DVT group and 134 patients the non-DVT group. Collected data included age, gender, history of glucocorticoid use, diabetes, hypertension, body mass index (BMI), triglyceride (TG) levels, cholesterol (CHOL) levels at admission, operative time, and postoperative bed rest duration. D-dimer (D-D) and fibrinogen (Fg) levels, along with the D-D/Fg ratio, were recorded on the first postoperative day. Group comparisons were performed using t-tests. Logistic regression analysis was conducted to identify independent risk factors, and the predictive value of these factors was evaluated using receiver operating characteristic (ROC) curve analysis. Results In the DVT group, 18 patients had diabetes. Levels of TG (1.78 ± 0.44 mmol/L), CHOL (4.70 ± 1.84 mmol/L), D-D (0.40 ± 0.17 mg/L), and the D-D/Fg ratio (0.24 ± 0.07) were significantly higher than in the non-DVT group (P < 0.05). Logistic regression identified TG, CHOL, D-D, and the D-D/Fg ratio as independent risk factors for DVT, with odds ratios of 0.987, 2.395, 0.8, 4.992, and 9.004, respectively (P < 0.05). ROC curve analysis yielded areas under the curve (AUCs) of 0.715, 0.69, 0.614, and 0.726 for TG, CHOL, D-D, and the D-D/Fg ratio, respectively. Sensitivities were 0.643, 0.500, 0.429, and 0.857, and specificities were 0.694, 0.978, 0.918, and 0.537, respectively. Conclusion Elevated levels of TG, CHOL, D-D, and the D-D/Fg ratio are independent risk factors for DVT following total hip arthroplasty in elderly patients. Among these, the D-D/Fg ratio demonstrated the highest sensitivity and may serve as an effective marker for early-stage DVT screening.

Keywords

deep venous thrombosis / total hip replacement / senile patients / risk factor / winter

Acknowledgement

Not applicable.

Research ethics

This study was approved by the Institutional Ethics Committee of the Second Affiliated Hospital of Harbin Medical University (KY2024-156).

Informed consent

Informed consent was obtained from all patients or their family members.

Author contributions

All authors contributed substantially to this work through study conception and design, data acquisition, analysis, and inter-pretation. Each author was involved in drafting the manuscript, revising it critically for important intellectual content, and providing final approval of the version to be published. All authors agree on the submission and assume full responsibility for the accuracy and integrity of the work.

Use of large language models, AI and machine learning tools

No LLM, AI or machine learning tool was used for any part of thepresent study.

Conflict of interest

The authors have not identified any potential conflicts of interest.

Data availability

Data supporting the findings of this study are available from the corresponding author upon reasonable request.

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