Department of Orthopedics, Dandong Central Hospital, China Medical University, Dandong, China.
Department of Orthopedics, Third Affiliated Hospital of Jinzhou Medical University, Jinzhou, China.
J Orthop Surg Res. 2023 Aug 31;18(1):645. doi: 10.1186/s13018-023-04139-z.
Hip fractures in the elderly are complicated by preoperative deep vein thrombosis (DVT). The objective of this study is to determine the usefulness of blood-based biomarkers, particularly the D-dimer-albumin ratio (DAR), in predicting preoperative DVT.
A retrospective observational study was carried out on 1149 patients from a single hospital, and subsequently validated on an additional 626 patients from a separate hospital. The aim was to evaluate the prognostic and predictive value of 10 biomarkers, with a specific emphasis on DAR, in both cohorts. The primary measure of interest was the occurrence of preoperative DVT.
The ratio of D-dimer to albumin demonstrated superior predictive capability for preoperative DVT in older patients with hip fractures compared to other biomarkers (AUC = 0.677). Using the optimal cutoff point of 0.24, high DAR was significantly associated with preoperative DVT (OR 3.45, 95% CI 2.00-5.95). Notably, all the DAR definitions detailed above were successfully validated in an external, independent cohort.
DAR may be a valuable biomarker for predicting preoperative DVT in elderly patients with hip fractures.
老年人髋部骨折术前易并发深静脉血栓形成（DVT）。本研究旨在确定基于血液的生物标志物，特别是 D-二聚体-白蛋白比值（DAR），在预测术前 DVT 中的作用。
对来自一家医院的 1149 例患者进行回顾性观察性研究，随后对另一家医院的 626 例患者进行验证。目的是评估 10 种生物标志物在两个队列中的预后和预测价值，特别关注 DAR。主要观察指标为术前 DVT 的发生。
与其他生物标志物相比，D 二聚体与白蛋白的比值在老年髋部骨折患者中对术前 DVT 的预测能力更优（AUC=0.677）。使用最佳截断值 0.24，高 DAR 与术前 DVT 显著相关（OR 3.45，95%CI 2.00-5.95）。值得注意的是，上述所有 DAR 定义在外部独立队列中均得到成功验证。
DAR 可能是预测老年髋部骨折患者术前 DVT 的有价值的生物标志物。
