Li Dong-Yang, Lu Dong-Xing, Yan Ting, Zhang Kai-Yuan, Zhang Bin-Fei, Zhang Yu-Min
Department of Orthopedic Trauma, Honghui Hospital, Xi'an Jiaotong University, Xi'an 710054, China.
Department of Ultrasound Medicine, Honghui Hospital, Xi'an Jiaotong University, Xi'an 710054, China.
J Clin Med. 2023 Jan 2;12(1):353. doi: 10.3390/jcm12010353.
Hematocrit, a commonly used hematological indicator, is a simple and easily applicable test. As a marker of anisocytosis and anemia, it indicates the percentage of blood cells per unit volume of whole blood. This study aimed to evaluate the association between the level of the hematocrit at admission and preoperative deep vein thrombosis (DVT) in hip fractures of older people. We collected the demographic and clinical characteristics of patients with geriatric hip fractures between 1 January 2015, and 30 September 2019, at the largest trauma center in northwestern China. Doppler ultrasonography was used to diagnose DVT. The correlation between hematocrit levels at admission and preoperative DVT was assessed using linear and nonlinear multivariate logistic regression, according to the adjusted model. All analyzes were performed using EmpowerStats and R software. In total, 1840 patients were included in this study, of which 587 patients (32%) had preoperative DVT. The mean hematocrit level was 34.44 ± 5.64 vol%. Linear multivariate logistic regression models showed that admission hematocrit levels were associated with preoperative DVT (OR = 0.97, 95% CI: 0.95−0.99; p = 0.0019) after adjustment for confounding factors. However, the linear association was unstable, and nonlinearity was identified. An admission hematocrit level of 33.5 vol% was an inflection point for the prediction. Admission hematocrit levels <33.5 vol% were not associated with preoperative DVT (OR = 1.00, 95% CI: 0.97−1.04, p = 0.8230), whereas admission hematocrit levels >33.5 vol% were associated with preoperative DVT (OR = 0.94, 95% CI: 25 0.91−0.97, p = 0.0006). Hematocrit levels at admission were nonlinearly associated with preoperative DVT, and hematocrit at admission was a risk factor for preoperative DVT. However, the severity of a low hematocrit was not associated with preoperative DVT when the hematocrit was <33.5 vol%.
血细胞比容是一种常用的血液学指标，是一项简单且易于应用的检测。作为红细胞大小不均一性和贫血的标志物，它表示全血中每单位体积血细胞的百分比。本研究旨在评估老年人髋部骨折入院时血细胞比容水平与术前深静脉血栓形成（DVT）之间的关联。我们收集了2015年1月1日至2019年9月30日期间中国西北部最大创伤中心老年髋部骨折患者的人口统计学和临床特征。采用多普勒超声诊断DVT。根据校正模型，使用线性和非线性多因素逻辑回归评估入院时血细胞比容水平与术前DVT之间的相关性。所有分析均使用EmpowerStats和R软件进行。本研究共纳入1840例患者，其中587例（32%）有术前DVT。血细胞比容平均水平为34.44±5.64体积%。线性多因素逻辑回归模型显示，在校正混杂因素后，入院时血细胞比容水平与术前DVT相关（OR=0.97，95%CI：0.95−0.99；p=0.0019）。然而，线性关联不稳定，且存在非线性关系。入院时血细胞比容水平33.5体积%是预测的拐点。入院时血细胞比容水平<33.5体积%与术前DVT无关（OR=1.00，95%CI：0.97−1.04，p=0.8230），而入院时血细胞比容水平>33.5体积%与术前DVT相关（OR=0.94，95%CI：0.91−0.97，p=0.0006）。入院时血细胞比容水平与术前DVT呈非线性相关，入院时血细胞比容是术前DVT的危险因素。然而，当血细胞比容<33.5体积%时，低血细胞比容的严重程度与术前DVT无关。
