Postoperative Plasma D-Dimer Value for Predicting Deep Venous Thrombosis following Hip Arthroplasty with Nadroparin Prophylaxis

Shi, Dongquan; Zhang, Cheng-ji; Chen, Dongyang; Dai, Jin; Teng, Huajian; Jiang, Qing

doi:10.5301/hipint.5000039

Cited by 12 publications

(3 citation statements)

References 26 publications

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“…Numerous studies have demonstrated the association of inflammatory status with hypercoagulability status [ 13 , 14 ]. Moreover, various inflammatory biomarkers with predictive significance in the diagnosis of post-TKA DVT have been studied in the last ten years [ 15 , 16 , 17 ]. Interleukin-6 (IL-6) and C-reactive protein (CRP) are two of the most studied inflammatory biomarkers in the prediction of complications following TKA [ 18 , 19 , 20 , 21 ], but unfortunately, the results are inconsistent and unsatisfactory, with high sensitivity but low specificity [ 22 , 23 ].…”

Section: Introductionmentioning

confidence: 99%

Inflammatory Biomarkers as Prognostic Factors of Acute Deep Vein Thrombosis Following the Total Knee Arthroplasty

Melinte

Arbănași²,

Blesneac

et al. 2022

Medicina

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Background and objectives: Deep vein thrombosis (DVT) is one of the most serious post-operative complications in the case of total knee arthroplasty (TKA). This study aims to verify the predictive role of inflammatory biomarkers [monocyte-to-lymphocyte ratio (MLR), neutrophil-to-lymphocyte ratio (NLR), platelets-to-lymphocyte ratio (PLR), systemic inflammatory index (SII), systemic inflammation response index (SIRI), and aggregate index of systemic inflammation (AISI)] in acute DVT following TKA. Materials and methods: The present study was designed as an observational, analytical, retrospective cohort study and included all patients over 18 years of age with surgical indications for TKA, admitted to the Department of Orthopedics, Regina Maria Health Network, Targu Mures, Romania, and the Department of Orthopedics, Humanitas MedLife Hospital, Cluj-Napoca, Romania between January 2017 and July 2022. The primary endpoint was the risk of acute DVT following the TKA, and the secondary endpoint was the length of hospital stay, and the outcomes were stratified for the baseline’s optimal MLR, NLR, PLR, SII, SIRI, and AISI cut-off value. Results: DVT patients were associated with higher age (p = 0.01), higher incidence of cardiac disease [arterial hypertension (p = 0.02), atrial fibrillation (p = 0.01)], malignancy (p = 0.005), as well as risk factors [smoking (p = 0.03) and obesity (p = 0.02)]. Multivariate analysis showed a high baseline value for all hematological ratios: MLR (OR: 11.06; p < 0.001), NLR (OR: 10.15; p < 0.001), PLR (OR: 12.31; p < 0.001), SII (OR: 18.87; p < 0.001), SIRI (OR: 10.86; p < 0.001), and AISI (OR: 14.05; p < 0.001) was an independent predictor of DVT after TKA for all recruited patients. Moreover, age above 70 (OR: 2.96; p = 0.007), AH (OR: 2.93; p = 0.02), AF (OR: 2.71; p = 0.01), malignancy (OR: 3.98; p = 0.002), obesity (OR: 2.34; p = 0.04), and tobacco (OR: 2.30; p = 0.04) were all independent predictors of DVT risk. Conclusions: Higher pre-operative hematological ratios MLR, NLR, PLR, SII, SIRI, and AISI values determined before operations strongly predict acute DVT following TKA. Moreover, age over 70, malignancy, cardiovascular disease, and risk factors such as obesity and tobacco were predictive risk factors for acute DVT.

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Section: Introductionmentioning

confidence: 99%

Inflammatory Biomarkers as Prognostic Factors of Acute Deep Vein Thrombosis Following the Total Knee Arthroplasty

Melinte

Arbănași²,

Blesneac

et al. 2022

Medicina

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“…Venography and ultrasound are commonly used diagnostic techniques for DVT, which are inconvenient, costly, or invasive. Many studies have focused on the serology, trying to find valuable biomarkers of DVT such as D-dimer, P-selection, Factor VII, and so on [ 4 – 6 ].…”

Section: Introductionmentioning

confidence: 99%

Predictive value of neutrophil to lymphocyte ratio and platelet to lymphocyte ratio for acute deep vein thrombosis after total joint arthroplasty: a retrospective study

et al. 2018

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BackgroundDeep vein thrombosis (DVT) is a common and severe complication of total joint arthroplasty (TJA). Inflammation has been proved to play a role in DVT. The neutrophil to lymphocyte ratio (NLR) and the platelet to lymphocyte ratio (PLR) are biomarkers for systemic inflammation. The aim of the study is to investigate the predictive value of NLR and PLR for acute TJA-induced DVT.MethodA total of 773 patients who underwent primary TJA in our hospital were included in this retrospective study. Venography was performed routinely after the surgery to define acute DVT. NLR and PLR before and after operation were calculated according to the blood routine test. Multiple logistic regression analyses and ROC curve analyses were performed to assess the association of NLR and PLR with TJA-induced DVT.ResultsOne hundred twenty out of 773 patients (15.5%) were diagnosed with DVT by venography. In patients with DVT, preoperative NLR (P = 0.030) and postoperative NLR (P = 0.015) were significantly higher but postoperative PLR (P = 0.002) was significantly lower. Multiple logistic regression analyses indicated that age (OR = 1.05, P < 0.005), gender (OR = 0.47, P = 0.005), BMI (OR = 1.06, P < 0.014), preoperative NLR (OR = 1.11, P < 0.035), postoperative NLR (OR = 1.20, P < 0.001), and PLR (OR = 0.99, P < 0.001) were independently associated with DVT. However, the ROC curve analysis demonstrated the specificity and sensitivity of NLR or PLR in predicting DVT were low.ConclusionAlthough the present study demonstrated significant association of perioperative NLR or PLR with acute TJA-induced DVT, NLR or PLR cannot predict TJA-induced DVT accurately.

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“…d -dimer, a predictive factor for VTE, is widely used in clinical practice as a diagnostic aid for suspected VTE. [27,28] In our study, the preoperative values of d -dimer were mostly in normal range, showed no significant differences in DVT group and non-DVT group. And the results of duplex ultrasonography, bilateral venography and CT pulmonary angiography preoperatively were negative.…”

Section: Discussionmentioning

confidence: 44%

High preoperative serum leptin level is an independent risk factor for deep vein thrombosis after total knee arthroplasty in osteoarthritis patients

Zhou

Xue

et al. 2018

Medicine

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It suggests that a high leptin level may increase the risk of venous thromboembolism (VTE) in animal studies. However, clinical studies in this field are still largely unexplored. Our objective was to evaluate the relationship between the preoperative serum leptin levels and postoperative VTE incidence in osteoarthritis (OA) patients who underwent total knee arthroplasty (TKA) at our institute.We conducted a prospective and cross-sectional study in these OA patients from March 2014 to March 2016. Preoperative leptin levels were analyzed by Luminex assays. VTE was assessed preoperatively and on postoperative day 5 and 7. The potential risk factors for VTE were also documented.We enrolled 203 OA patients. No PE was detected and DVT was diagnosed in 34 patients postoperatively. There were significant differences between the median leptin levels in DVT group and non-DVT group [25.13 ng/mL (interquartile range, 14.51-44.31) vs 18.71 ng/mL (8.26-28.99), P = .007]. The relative risk of DVT significantly increased with natural logarithm (ln) leptin (per SD increase) (OR 2.37, 95% confidence interval (95% CI), 1.29-4.33, P = .005). Multivariate analyses adjusted for potential confounders showed ln leptin (per SD increase) was significantly associated with the relative risk of DVT (OR 2.17, 95% CI, 1.01-4.64, P = .046). When patients were subdivided into tertiles according to their leptin values, the OR for DVT increased with increasing tertiles of serum leptin (OR 1.03, 95% CI, 1.01-1.06, P for trend = .023).In the present study, our results indicate that a high preoperative leptin level may be an independent risk factor for postoperative DVT.

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Postoperative Plasma D-Dimer Value for Predicting Deep Venous Thrombosis following Hip Arthroplasty with Nadroparin Prophylaxis

Cited by 12 publications

References 26 publications

Inflammatory Biomarkers as Prognostic Factors of Acute Deep Vein Thrombosis Following the Total Knee Arthroplasty

Inflammatory Biomarkers as Prognostic Factors of Acute Deep Vein Thrombosis Following the Total Knee Arthroplasty

Predictive value of neutrophil to lymphocyte ratio and platelet to lymphocyte ratio for acute deep vein thrombosis after total joint arthroplasty: a retrospective study

High preoperative serum leptin level is an independent risk factor for deep vein thrombosis after total knee arthroplasty in osteoarthritis patients

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