Fibrinogen-albumin-ratio is an independent predictor of deep vein thrombosis in patients undergoing knee arthroplasty

Abstract

Background

Deep vein thrombosis (DVT) is a prevalent complication of KA following knee arthroplasty (KA), leading to the development of post-thrombotic syndrome (PTS). PTS is associated with declining quality of life (QoL) and increased treatment costs. This study aims to investigate the correlation between fibrinogen to albumin ratio (FAR) and lower extremity DVT and evaluate the predictive value of FAR in diagnosing DVT post-KA.

Methods

A total of 331 patients undergoing KA at the Department of Joint Surgery between August 2020 and August 2022 were included in this study. Among them,38 patients with DVT identified through post-operative routine color Doppler flow imaging (CDFI) comprised the study group, while 278 patients without DVT formed the control group. Pre-operative FAR ratios were analyzed to investigate the association between pre-operative FAR and lower extremity DVT following KA.

Results

No significant differences were observed in the basic characteristics between the two groups. Additionally, there were no statistically significant differences in the laboratory values, including white blood cells, neutrophils, hemoglobin, fibrinogen, albumin, and platelets before and after surgery. However, the pre-operative FAR in patients with DVT was significantly higher than that in the control group (0.077 ± 0.007 vs. 0.067 ± 0.012, P < 0.001). ROC curve analysis of FAR for predicting lower extremity DVT revealed a cut-off value of 0.070 (AUC = 0.732, P < 0.001), with a sensitivity of 94.7 % and specificity of 51.1 %. Multivariate logistic regression analysis showed pre-operative FAR was the only independent predictor of DVT post-KA (OR = 1.12, 95 %CI: 1.06–1.17, P < 0.001).

Conclusions

Pre-operative FAR has a good predictive capability for lower extremity DVT post-KA.Its detection may be a simple and useful method for the prediction of DVT in patients undergoing KA.