Wu Zhengsheng, Du Yaoqiang, Cai Xiaofeng, Xu Qian
Laboratory Medicine Center, Department of Transfusion Medicine, Zhejiang Provincial People's Hospital (Affiliated People's Hospital), Hangzhou Medical College, No.158 Shangtang Road, Hangzhou, 310014, Zhejiang, China.
Center for Rehabilitation Medicine, Department of Neurology, Zhejiang Provincial People's Hospital (Affiliated People's Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, China.
Sci Rep. 2025 Jan 13;15(1):1847. doi: 10.1038/s41598-025-85941-z.
Deep vein thrombosis (DVT) is one of the important factors leading to death in patients undergoing fracture surgery. This study aims to investigating the predictive value of the Caprini score combined with thrombus molecular markers for the risk of DVT in patients after traumatic fracture surgery. A total of 342 patients who underwent surgery for traumatic fractures were included in the study. The patients were divided into two groups based on the occurrence of DVT after surgery: the DVT group (n = 57) and the non-DVT group (n = 285). A univariate analysis and logistic regression analysis were conducted on clinical factors and laboratory indicators that might be associated with DVT in patients with traumatic fractures. A predictive model for DVT risk was then constructed by combining thrombus molecular markers with the Caprini score. The median age of all patients was 65 years (54-75 years), the postoperative Caprini score was 9 (6-11), and the length of hospital stay was 11 days (8-16 days). In univariate analysis, age (P = 0.029), postoperative Caprini score (P < 0.001), and length of hospital stay (P = 0.009) were significantly associated with the occurrence of DVT. Logistic regression analysis showed that the risk of developing DVT increased with higher postoperative Caprini scores (P < 0.001), longer hospital stays (P = 0.024), and higher PIC levels (P = 0.046). Among these, the postoperative Caprini score was the most effective factor for diagnosing DVT, with an area under the curve (AUC) of 0.814 (P < 0.001) and a diagnostic cutoff of 11 points. The overall diagnostic efficacy of individual thrombus molecular markers from highest to lowest was TM, DD, PIC, t-PAIC, and TAT, with all except TAT showing statistical significance. The combined diagnostic efficacy of the postoperative Caprini score and PIC also showed statistical significance (AUC = 0.869, P < 0.001). Thrombus molecular markers combined with the postoperative Caprini score have potential predictive value for the risk of DVT in patients after traumatic fracture surgery.
深静脉血栓形成（DVT）是导致骨折手术患者死亡的重要因素之一。本研究旨在探讨Caprini评分联合血栓分子标志物对创伤性骨折手术后患者发生DVT风险的预测价值。本研究共纳入342例接受创伤性骨折手术的患者。根据术后DVT的发生情况将患者分为两组：DVT组（n = 57）和非DVT组（n = 285）。对创伤性骨折患者中可能与DVT相关的临床因素和实验室指标进行单因素分析和逻辑回归分析。然后将血栓分子标志物与Caprini评分相结合，构建DVT风险预测模型。所有患者的中位年龄为65岁（54 - 75岁），术后Caprini评分为9分（6 - 11分），住院时间为11天（8 - 16天）。单因素分析显示，年龄（P = 0.029）、术后Caprini评分（P < 0.001）和住院时间（P = 0.009）与DVT的发生显著相关。逻辑回归分析表明，术后Caprini评分越高（P < 0.001）、住院时间越长（P = 0.024）和PIC水平越高（P = 0.046），发生DVT的风险越高。其中，术后Caprini评分是诊断DVT最有效的因素，曲线下面积（AUC）为0.814（P < 0.001），诊断临界值为11分。单个血栓分子标志物的总体诊断效能从高到低依次为TM、DD、PIC、t - PAIC和TAT，除TAT外均具有统计学意义。术后Caprini评分与PIC的联合诊断效能也具有统计学意义（AUC = 0.869，P < 0.001）。血栓分子标志物与术后Caprini评分相结合对创伤性骨折手术后患者发生DVT的风险具有潜在的预测价值。
