Prediction and Risk Factors of Lower Extremity Deep Vein Thrombosis after Total Joint Arthroplasty.

Abstract

This study was to retrospectively analyze the incidence of deep vein thrombosis (DVT) in patients undergoing total joint arthroplasty (TJA) and analyze the risk factors for DVT. 113 patients with TJA were divided into the DVT group (n = 11) and the non-DVT group (n = 102) according to the postoperative ultrasound diagnosis, and the incidence of DVT after TJA was calculated. Logistic regression was used to analyze the correlation between DVT and patients' age, medical history, surgical factors, blood indexes to identify the risk factors of DVT after TJA. Receiver operator characteristic (ROC) curve was constructed to evaluate the diagnostic accuracy of risk factors for DVT. According to the results of ultrasound examination, DVT occurred in 11 of 113 patients after TJA, and the incidence rate of DVT was 9.73%. Univariate analysis showed that the levels of age, diabetes mellitus, operation time, intraoperative blood loss, intraoperative blood transfusion, antithrombin-Ⅲ (AT-Ⅲ), plasma protein C (PC), soluble platelet endothelial cell adhesion molecules-1 (SPECAM-1) and tissue-type plasminogen activator (t-PA) in the DVT group were significantly different from those in the non-DVT group (P < 0.05). Multivariate analysis showed that combined diabetes, decreased PC and t-PA were risk factors for DVT (P < 0.05). ROC analysis showed that PC combined with t-PA had the highest diagnostic accuracy for DVT. Patients with diabetes mellitus are at high risk for DVT after TJA, the increase of D-dimer, the decrease of PC and t-PA after 24 h of TJA is the the risk factors for DVT occurrence.