Risk factors and prediction model of nomogram for preoperative calf muscle vein thrombosis in geriatric hip fracture patients

Jiabao Jiang; Fei Xing; Rong Luo; Zhao Chen; Hao Liu; Zhou Xiang; Xin Duan

doi:10.3389/fmed.2023.1236451

Risk factors and prediction model of nomogram for preoperative calf muscle vein thrombosis in geriatric hip fracture patients

Front Med (Lausanne). 2023 Sep 1:10:1236451. doi: 10.3389/fmed.2023.1236451. eCollection 2023.

Authors

Jiabao Jiang¹, Fei Xing¹, Rong Luo¹, Zhao Chen¹, Hao Liu¹, Zhou Xiang^{1

2}, Xin Duan^{1

3}

Affiliations

¹ Department of Orthopedic Surgery, Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
² Department of Orthopedics Surgery, West China Sanya Hospital, Sichuan University, Sanya, Hainan, China.
³ Department of Orthopedic Surgery, The Fifth People's Hospital of Sichuan Province, Chengdu, Sichuan, China.

Abstract

Introduction: Calf muscular vein thrombosis (CMVT) is a common complication in geriatric hip fracture patients. Despite its high incidence, prior research on the topic is limited. The occurrence of CMVT in patients will prolong the preoperative waiting time and even lead to serious thromboembolic events, which can be detrimental to the patient's prognosis. Therefore, this study aimed to identify the risk factors for preoperative CMVT in geriatric hip fracture patients and construct a nomogram model to predict the risk of preoperative CMVT in patients.

Materials and methods: Geriatric hip fracture patients who underwent surgery between January 2019 and January 2022 were included. The patients were categorized into two groups depending on whether they had preoperative CMVT, confirmed through Color Doppler ultrasound or venography examination. Univariate and multivariate logistic regression analyses were used to analyze demographic characteristics, medical history, comorbidities, and laboratory tests. A nomogram was constructed to predict preoperative CMVT in geriatric hip fracture patients based on the results of the multivariate logistic regression.

Results: Three hundred and eighty-eight geriatric hip fracture patients, including one hundred and thirty-four patients with CMVT and two hundred and fifty-four patients without CMVT, were ultimately included in our study. After multivariable logistic regression analysis, the time from injury to admission, smoking history, serum albumin levels, and D-dimer levels was identified as independent risk factors and was entered into a nomogram model. The nomogram showed robust discrimination, with an area under the receiver operating characteristic curve of 0.805. The calibration curve showed strong agreement between the CMVT probabilities predicted by the nomogram and the actual probabilities. The decision curve analysis illustrates the excellent clinical utility of the model.

Conclusion: We have constructed a new nomogram prediction model that can effectively predict the risk of preoperative CMVT in geriatric hip fracture patients based on their medical history and blood test results. This model can help clinicians make individualized predictions of CMVT that are tailored to each patient's unique circumstances.

Keywords: calf muscular vein thrombosis; deep vein thrombosis; geriatric hip fracture; nomogram; risk factors.