Association Between Red Blood Cell Indices and Preoperative Deep Vein Thrombosis in Patients Undergoing Total Joint Arthroplasty: A Retrospective Study

Abstract

Purpose To investigate the association of red blood cell (RBC), hemoglobin (Hb), red cell distribution width-coefficient of variation (RDW-CV), and red cell distribution width-standard deviation (RDW-SD) with preoperative deep vein thrombosis (DVT) in patients undergoing total joint arthroplasty (TJA). Methods A total of 2059 TJA patients were enrolled. We used the ratios of RBC, Hb, RDW-CV, and RDW-SD to DVT before TJA to create the receiver operator characteristic (ROC) curve, thereby calculating the cut-off values and the area under the curve (AUC). The patients were categorized into groups based on cut-off value, and risk factors for DVT before TJA were subsequently analyzed. We included the variates that were statistically significant in the univariate analysis in the multivariate binary logistic regression analysis. Results Preoperative DVT occurred in 107 cases (5.20%). Based on the ROC curve, we found that the AUC for RBC, Hb, RDW-CV, and RDW-SD were 0.658, 0.646, 0.568, and 0.586, respectively. Multivariate binary regression analysis revealed that the risk of preoperative DVT in TJA patients with RBC≤3.92*109 /L, Hb≤118g/L, RDW-CV≥13.2%, and RDW-SD≥44.6fL increased 3.02 ( P < 0.001, 95% confidence interval (CI) [2.0–4.54]), 2.15 ( P < 0.001, 95% CI [1.42–3.24]), 1.54 ( P = 0.038, 95% CI [1.03–2.3]), and 1.98 times ( P = 0.001, 95% CI [1.32–2.98]), respectively. The risk of preoperative DVT in patients with corticosteroid use increased approximately 2.6 times ( P = 0.002, 95% CI [1.22–5.81]). Conclusion We found that decreased RBC and Hb, increased RDW-CV and RDW-SD, and corticosteroid use were independent risk factors for preoperative DVT in patients undergoing TJA.

Association of the neutrophil-to-lymphocyte ratio with the occurrence of venous thromboembolism and arterial thrombosis

“…Some studies have indicated that a high hemoglobin level is a risk factor for VTE; however, no study has shown a difference between VTE subgroups. [35][36][37] In general, studies on the value of a high NLR in increasing the risk of VTE are controversial. There is still a long distance from mouse model study results to their clinical application.…”

Association between systemic immune-inflammation index and risk of lower extremity deep venous thrombosis in hospitalized patients: a 10-year retrospective analysis

“…After blood drawing, routine blood tests were performed immediately using automatic hematology analyzers (Sysmex XN2000, Kobe, Japan). In this study, several hematological indicators closely related to DVT were collected, including white blood cell (WBC, reference range: 3.5-9.5 × 10 9 /L) (22), red blood cell (RBC, reference range: 3.8-5.1 × 10 9 /L) (23), and hemoglobin (reference range: 115.0-150.0 g/L) (24).…”