A Nomogram Model to Predict Deep Vein Thrombosis Risk After Surgery in Patients with Hip Fractures

Overview

Journal Indian J Orthop

Publisher Springer Nature

Specialty Orthopedics

Date 2024 Feb 5

PMID 38312904

Authors

Ruting Bo

Xiaoyu Chen

Xiuwei Zheng

Yang Yang

Bing Dai

Yu Yuan

Affiliations

Soon will be listed here.

Abstract

Aims: This study aimed to establish a nomogram model for predicting the probability of postoperative deep vein thrombosis (DVT) risk in patients with hip fractures.

Methods: 504 patients were randomly assigned to the training set and validation set, and then divided into a DVT group and a non-DVT group. The study analysed the risk factors for DVT using univariate and multivariate analyses. Based on these parameters, a nomogram model was constructed and validated. The predicting performance of nomogram was evaluated by discrimination, calibration, and clinical usefulness.

Results: The predictors contained in the nomogram model included age, surgical approach, 1-day postoperative -dimer value and admission ultrasound diagnosis of the lower limb vein. Furthermore, the area under the ROC curve (AUC) for the specific DVT risk-stratification nomogram model (0.815; 95% CI 0.746-0.884) was significantly higher than the current model (Caprini) (0.659; 95% CI 0.572-0.746, < 0.05). According to the calibration plots, the prediction and actual observation were in good agreement. In the range of threshold probabilities of 0.2-0.8, the predictive performance of the model on DVT risk could be maximized.

Conclusions: The current predictive model could serve as a reliable tool to quantify the possibility of postoperative DVT in hip fractures patients.

References

Schellong S, Ageno W, Casella I, Chee K, Schulman S, Singer D . Profile of Patients with Isolated Distal Deep Vein Thrombosis versus Proximal Deep Vein Thrombosis or Pulmonary Embolism: RE-COVERY DVT/PE Study. Semin Thromb Hemost. 2021; 48(4):446-458. PMC: 9246482. DOI: 10.1055/s-0041-1729169. View

Feng L, Xu L, Yuan W, Xu Z, Feng Z, Zhang H . Preoperative anemia and total hospitalization time are the independent factors of preoperative deep venous thromboembolism in Chinese elderly undergoing hip surgery. BMC Anesthesiol. 2020; 20(1):72. PMC: 7114807. DOI: 10.1186/s12871-020-00983-2. View

Hazeltine M, Scott E, Dorfman J . An abbreviated Caprini model for VTE risk assessment in trauma. J Thromb Thrombolysis. 2021; 53(4):878-886. DOI: 10.1007/s11239-021-02611-3. View

Li X, Ye Z, Lin S, Pang H . Predictive factors for survival following stereotactic body radiotherapy for hepatocellular carcinoma with portal vein tumour thrombosis and construction of a nomogram. BMC Cancer. 2021; 21(1):701. PMC: 8204556. DOI: 10.1186/s12885-021-08469-1. View

Yao Y, Qiao L, Song K, Xu X, Shi D, Xu Z . Preoperative Evaluation of Soleal Vein Diameter by Ultrasound Is Beneficial for Prophylaxis of Deep Vein Thrombosis after Total Knee or Hip Arthroplasty. Biomed Res Int. 2018; 2018:3417648. PMC: 6120296. DOI: 10.1155/2018/3417648. View

Wang P, Li J, Fei C, Li Z, Ke C, Shang K . Deep Vein Thrombosis in the Uninjured Limb in Patients with Lower Extremity Fractures: A Retrospective Study. Biomed Res Int. 2020; 2020:1647617. PMC: 7330622. DOI: 10.1155/2020/1647617. View

Temgoua M, Tochie J, Noubiap J, Agbor V, Danwang C, Endomba F . Global incidence and case fatality rate of pulmonary embolism following major surgery: a protocol for a systematic review and meta-analysis of cohort studies. Syst Rev. 2017; 6(1):240. PMC: 5716368. DOI: 10.1186/s13643-017-0647-8. View

Yuan H, Zhang X, Li Y, Guan Q, Chu W, Yu H . A Nomogram for Predicting Risk of Thromboembolism in Gastric Cancer Patients Receiving Chemotherapy. Front Oncol. 2021; 11:598116. PMC: 8187914. DOI: 10.3389/fonc.2021.598116. View

Kahr H, Christiansen O, Grove A, Iyer V, Torp-Pedersen C, Knudsen A . Venous thromboembolism in epithelial ovarian cancer. A prospective cohort study. Thromb Res. 2019; 181:112-119. DOI: 10.1016/j.thromres.2019.07.027. View

10.

Zhang W, Liu X, Cheng H, Yang Z, Zhang G . Risk factors and treatment of venous thromboembolism in perioperative patients with ovarian cancer in China. Medicine (Baltimore). 2018; 97(31):e11754. PMC: 6081089. DOI: 10.1097/MD.0000000000011754. View

11.

Huang M, Ye D, Lin Y, Lu X, Lin H, Chi P . A nomogram for predicting rectovaginal fistula after low anterior resection for rectal cancer. Surg Today. 2020; 50(10):1206-1212. DOI: 10.1007/s00595-020-02049-9. View

12.

Lin Z, Mi B, Liu X, Panayi A, Xiong Y, Xue H . Nomogram for Predicting Deep Venous Thrombosis in Lower Extremity Fractures. Biomed Res Int. 2021; 2021:9930524. PMC: 8245242. DOI: 10.1155/2021/9930524. View

13.

Zhang S, Shen G, Luo M, Zhong X . Analysis of Related Influencing Factors of Deep Vein Thrombosis after Lumbar Internal Fixation and Treatment Strategy. Evid Based Complement Alternat Med. 2021; 2021:9693012. PMC: 8548089. DOI: 10.1155/2021/9693012. View

14.

Zhou Q, Zhu C, Shen Z, Zhang T, Li M, Zhu J . Incidence and potential predictors of thromboembolic events in epithelial ovarian carcinoma patients during perioperative period. Eur J Surg Oncol. 2020; 46(5):855-861. DOI: 10.1016/j.ejso.2020.01.026. View

15.

Song K, Yao Y, Rong Z, Shen Y, Zheng M, Jiang Q . The preoperative incidence of deep vein thrombosis (DVT) and its correlation with postoperative DVT in patients undergoing elective surgery for femoral neck fractures. Arch Orthop Trauma Surg. 2016; 136(10):1459-64. DOI: 10.1007/s00402-016-2535-4. View

16.

Shahi A, Chen A, Tan T, Maltenfort M, Kucukdurmaz F, Parvizi J . The Incidence and Economic Burden of In-Hospital Venous Thromboembolism in the United States. J Arthroplasty. 2016; 32(4):1063-1066. DOI: 10.1016/j.arth.2016.10.020. View

17.

Liang M, Chen M, Singh S, Singh S . Prognostic Nomogram for Overall Survival in Small Cell Lung Cancer Patients Treated with Chemotherapy: A SEER-Based Retrospective Cohort Study. Adv Ther. 2021; 39(1):346-359. DOI: 10.1007/s12325-021-01974-6. View

18.

Tasaka N, Minaguchi T, Hosokawa Y, Takao W, Itagaki H, Nishida K . Prevalence of venous thromboembolism at pretreatment screening and associated risk factors in 2086 patients with gynecological cancer. J Obstet Gynaecol Res. 2020; 46(5):765-773. DOI: 10.1111/jog.14233. View

19.

An C, Huang Z, Ni J, Zuo M, Jiang Y, Zhang T . Development and validation of a clinicopathological-based nomogram to predict seeding risk after percutaneous thermal ablation of primary liver carcinoma. Cancer Med. 2020; 9(18):6497-6506. PMC: 7520297. DOI: 10.1002/cam4.3250. View

20.

Zhang H, Xu M, Yang X, Wang F, Zhang H, Yang L . Nomogram for Predicting the Postoperative Venous Thromboembolism in Spinal Metastasis Tumor: A Multicenter Retrospective Study. Front Oncol. 2021; 11:629823. PMC: 8264656. DOI: 10.3389/fonc.2021.629823. View