Predictive value of D-dimer/platelet ratio combined with Caprini score for deep vein thrombosis after hemiarthroplasty in the elderly

Ran Xuhong; Lin Zhiguo; You Bin; Liao Tiancheng; Liu Qiangfu; Chen Guo; Xie Xiaochuan

doi:10.11986/j.issn.1673-873X.2024.11.08

Abstract：Objective To explore the predictive value of D-dimer/platelet(PLT)ratio(DPR)combined with Caprini score for deep vein thrombosis(DVT)after hemiarthroplasty in the elderly,aiming to provide a reference for preventing DVT in elderly patients after hemiarthroplasty.Methods A total of 102 elderly patients who underwent hemiarthroplasty at our hospital from January 2021 to January 2024 were selected as the study participants.Patients were allocated to a thrombus group(n=25)and a non-thrombus group(n=77)based on the occurrence of DVT,as detected by color Doppler ultra-sound.The DPR and Caprini scores were compared between the two groups.The receiver operating characteristic(ROC)curve was used to assess the predictive value of DPR,Caprini score,and their combination for DVT after hemiarthroplasty in the elderly.Multivariate logistic regression analysis was used to identify factors influencing DVT after hemiarthroplasty in the elderly.Results The DPR and Caprini scores in the thrombus group were significantly higher than those in the non-thrombus group(P＜0.05).The area under the curve(AUC)for predicting DVT after hemiarthroplasty in the elderly u-sing DPR and Caprini score were 0.794(95％CI:0.749-0.844)and 0.862(95％CI:0.817-0.912),respectively,while the combined prediction AUC was 0.911(95％CI:0.860-0.958).No significant differences were noted in age,gender,smoking history,alcohol consumption history,hypertension,surgical position,surgical duration,intraoperative blood loss,postoperative drainage volume,and postoperative length of hospital stay between the non-thrombus and thrombus groups(P＞0.05).The body mass index,proportion of diabetes mellitus,and Wells score in the thrombus group were higher than those in the non-thrombus group(P＜0.05).Multivariate logistic regression analysis showed body mass index ≥23.09 kg/m2(OR=2.596,95％CI:1.641-4.107),diabetes mellitus(OR=2.889,95％CI:1.705-4.895),Wells score ≥1.79(OR=2.394,95％CI:1.493-3.840),DPR ≥1.47 X 10-2(OR=3.155,95％CI:1.944-5.120),and Caprini score ≥5.50(OR=3.377,95％CI:2.065-5.523)were risk factors for DVT after hemiarthroplasty in the elderly(P＜0.05).Conclusion The combination of DPR and Caprini score can serve as an important indicator for assessing the occurrence of DVT after hemiarthroplasty in the elderly,with high sensitivity and specificity.Clinically,close monito-ring of DPR and Caprini score in elderly patients after hemiarthroplasty can help prevent the occurrence of DVT.