Department of Anesthesiology, 66307Army Medical Center of PLA, Daping Hospital, Army Medical University, Chongqing, China.
Department of Anesthesiology, 117972The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Clin Appl Thromb Hemost. 2022 Jan-Dec;28:10760296221149029. doi: 10.1177/10760296221149029.
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).
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.
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*10 /L, Hb≤118g/L, RDW-CV≥13.2%, and RDW-SD≥44.6fL increased 3.02 ( < 0.001, 95% confidence interval (CI) [2.0-4.54]), 2.15 ( < 0.001, 95% CI [1.42-3.24]), 1.54 ( = 0.038, 95% CI [1.03-2.3]), and 1.98 times ( = 0.001, 95% CI [1.32-2.98]), respectively. The risk of preoperative DVT in patients with corticosteroid use increased approximately 2.6 times ( = 0.002, 95% CI [1.22-5.81]).
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.
探讨红细胞（RBC）、血红蛋白（Hb）、红细胞分布宽度变异系数（RDW-CV）和红细胞分布宽度标准差（RDW-SD）与接受全关节置换术（TJA）的患者术前深静脉血栓形成（DVT）的关系。
共纳入 2059 例 TJA 患者。我们使用 RBC、Hb、RDW-CV 和 RDW-SD 与 TJA 前 DVT 的比值来创建受试者工作特征（ROC）曲线，从而计算出截断值和曲线下面积（AUC）。根据截断值将患者分为不同组，随后分析 TJA 前 DVT 的危险因素。我们将单因素分析中具有统计学意义的变量纳入多因素二项逻辑回归分析。
术前 DVT 发生 107 例（5.20%）。根据 ROC 曲线，我们发现 RBC、Hb、RDW-CV 和 RDW-SD 的 AUC 分别为 0.658、0.646、0.568 和 0.586。多因素二项逻辑回归分析显示，RBC≤3.92*10/L、Hb≤118g/L、RDW-CV≥13.2%和 RDW-SD≥44.6fL 的 TJA 患者术前 DVT 风险分别增加 3.02（ < 0.001，95%置信区间（CI）[2.0-4.54]）、2.15（ < 0.001，95% CI [1.42-3.24]）、1.54（ = 0.038，95% CI [1.03-2.3]）和 1.98 倍（ = 0.001，95% CI [1.32-2.98]）。使用皮质类固醇的患者术前 DVT 风险增加约 2.6 倍（ = 0.002，95% CI [1.22-5.81]）。
我们发现 RBC 和 Hb 降低、RDW-CV 和 RDW-SD 增加以及使用皮质类固醇是 TJA 患者术前 DVT 的独立危险因素。
