D-Dimer and Fibrinogen Values according to the Localization of Deep Venous Thrombosis

Prediction of risk factors for preoperative deep vein thrombosis in patients with pelvic fracture

Objective

This study aims to develop a preoperative risk assessment tool for deep vein thrombosis (DVT) in pelvic fracture patients, offering evidence-based guidance for surgeons.

Methods

A cohort of 400 pelvic fracture patients was analyzed. Ten candidate predictors were initially identified via LASSO regression from 25 clinical variables. Four independent risk factors-emergency abdominal surgery, Injury Severity Score (ISS), serum creatinine levels, and aspartate aminotransferase (AST)-were subsequently incorporated into a multivariate logistic regression model. A nomogram was developed using R software, with calibration accuracy assessed via the rms package and clinical utility evaluated through decision curve analysis (DCA) using the ggDCA package.

Results

The final model demonstrated excellent discriminative ability, with area under the curve (AUC) values of 0.88 (95% CI: 0.81-0.93) in the training cohort and 0.88 (95% CI: 0.80-0.95) in the validation cohort. Calibration curves confirmed strong alignment between predicted and observed DVT probabilities, while DCA highlighted the nomogram's clinical applicability across a wide risk threshold range.

Conclusion

The validated nomogram provides a reliable preoperative tool for stratifying DVT risk in pelvic fracture patients. By enabling early identification of high-risk individuals, this model supports targeted prophylactic interventions, ultimately enhancing perioperative safety and patient outcomes.

Coagulation parameters correlate to venous thromboembolism occurrence during the perioperative period in patients with spinal fractures

BACKGROUND

Venous thromboembolism (VTE) is one of the leading causes of mortality in hospitalized patients. However, whether the coagulation-related parameters of the hospitalized patients could be used to predict the occurrence of VTE in patients with spinal injury surgery remained unclear.

METHOD

The patients with spinal fractures who met the inclusion and exclusion criteria were enrolled to be analyzed using a retrospective analysis approach. The association of risk factors of enrolled patients and operations to VTE occurrence were analyzed. The activated partial thromboplastin time, prothrombin time, thrombin time, D-dimer (D-D), fibrinogen (FIB) and fibrinogen degradation products (FDP) were detected. ROC and HR analysis were applied to evaluate the correlation of coagulation-related parameters and other parameters to VTE occurrence.

RESULT

The indicators of D-D, FIB and FDP were significantly elevated in VTE patients compared to non-VTE patients. The multivariate analysis of OR showed that six risk factors, including age ≥ 60, spinal cord injury, postoperative bedtime over 5 days, plasma D-dimer ≥ 0.54 mg/L, plasma fibrinogen ≥ 3.75 g/L and plasma FDP ≥ 5.19 mg/L, were positively correlated to VTE.

CONCLUSION

The six risk factors, including D-D, FIB, FDP, age ≥ 60, spinal cord injury, and postoperative bedtime over 5 days, could be used to predict the occurrence of VTE.