Analysis of risk factors for lower deep vein thrombosis (DVT) in patients over 60 years of age after total hip arthroplasty.

Abstract

Objective: To comprehensively analyze and evaluate risk factors for lower extremity deep vein thrombosis (DVT) in patients aged ≥ 60 years following total hip arthroplasty (THA), and to provide evidence-based recommendations for DVT prevention.

Methods: A total of 462 patients who underwent THA at the our hospital from January 2019 to December 2023 were included in the study. Based on the occurrence of lower extremity deep vein thrombosis during follow-up, patients were divided into a DVT group (n = 65) and a non-DVT group (n = 397). The following variables were retrospectively analyzed for both groups: gender, age, body mass index, smoking status, alcohol consumption, medical history, operative time, anesthesia method, and preoperative and postoperative laboratory indicators (including triglycerides, TC, fibrinogen, hemoglobin, red cell distribution width, albumin, platelet count, D-dimer, INR, and FDP). Univariate analysis was conducted for these factors, with statistically significant variables subsequently included in a binary logistic regression model to examine their association with post-THA lower extremity deep vein thrombosis. ROC curve analysis was employed to evaluate the sensitivity and specificity of individual risk factors for DVT diagnosis, followed by development of a multivariate combined ROC curve model to assess its diagnostic value for DVT.

Results: Binary logistic regression analysis revealed that preoperative hematocrit (P = 0.015, OR = 1.082), preoperative triglyceride levels (P = 0.030, OR = 1.275), preoperative platelet count (P = 0.008, OR = 1.005), preoperative D-dimer level (P < 0.001, OR = 3.407), diabetes mellitus (P = 0.004, OR = 2.735), smoking history (P = 0.003, OR = 2.733), and hypertension (P = 0.002, OR = 2.795) showed significant positive associations with lower extremity deep vein thrombosis following THA. These factors were identified as independent risk factors for post-THA DVT development.

Conclusion: Preoperative hematocrit, triglycerides (TG), platelet count, D-dimer levels, smoking status, along with pre-existing hypertension and diabetes mellitus were all identified as significant risk factors for developing deep vein thrombosis following total hip arthroplasty. Surgeons should conduct comprehensive preoperative assessments of these risk factors and implement individualized prevention and treatment protocols to minimize the occurrence of lower extremity deep vein thrombosis.