Association Between Platelet Indices and Preoperative Deep Vein Thrombosis in Elderly Patients Undergoing Total Joint Arthroplasty: A Retrospective Study

Prediction of deep vein thrombosis in pregnant women by platelet indices: A retrospective case-control study

AIMS

This study aimed to investigate the predictive value of the platelet indices for the diagnosis of acute deep vein thrombosis (DVT) in pregnant women.

MATERIALS AND METHODS

Pregnant women aged 20-45 years who presented to the emergency room with leg pain and edema and underwent bilateral lower extremity venous Doppler examination for DVT were included in the study. Platelet large cell ratio (P-LCR), platelet distribution width (PDW) and mean platelet volume (MPV) values, which provide information on current platelet activity in the hemogram parameters recorded at first presentation in the emergency department, were analyzed between the two groups. Pregnant women with a history of venous thromboembolism, anticoagulant medication, heart disease, cancer, essential thrombocytopenia, gestational thrombocytopenia, pulmonary embolism, and multiple pregnancies were excluded.

RESULTS

A total of 125 participants were included in the study. Acute DVT was diagnosed in 37 participants using venous Doppler of the lower extremities. In the remaining 88 patients, the diagnosis of DVT was excluded. There was no significant difference between the groups in terms of age, body mass index, parity, and gestational age at diagnosis. Although platelet counts were similar between groups, P-LCR, PDW, and MPV values, which provide information on platelet shape and volume, were statistically significantly lower in Group DVT (p < 0.05).

CONCLUSION

According to this study, low MPV, PDW and P-LCR values in pregnant women can be evaluated as independent markers in the diagnosis of acute DVT or these markers can be included in the DVT scoring system for pregnant women.

Establishment and validation of a nomogram predicting the risk of deep vein thrombosis before total knee arthroplasty

PURPOSE

This study aimed to analyze the independent risk factors contributing to preoperative DVT in TKA and constructed a predictive nomogram to accurately evaluate its occurrence based on these factors.

METHODS

The study encompassed 496 patients who underwent total knee arthroplasty at our hospital between June 2022 and June 2023. The dataset was randomly divided into a training set (n = 348) and a validation set (n = 148) in a 7:3 ratio. The least absolute shrinkage and selection operator (LASSO) and multivariate logistic regression analysis were used to screen the predictors of preoperative DVT occurrence in TKA and construct a nomogram. The performance of the predictive models was evaluated using the concordance index (C-index), calibration curves, and the receiver operating characteristic (ROC) curves. Decision curve analysis was used to analyze the clinical applicability of nomogram.

RESULTS

A total of 496 patients who underwent TKA were included in this study, of which 28 patients were examined for lower extremity DVT preoperatively. Platelet crit, Platelet distribution width, Procalcitonin, prothrombin time, and D-dimer were predictors of preoperative occurrence of lower extremity DVT in the nomograms of the TKA patients. In addition, the areas under the curve of the ROC of the training and validation sets were 0.935 (95%CI: 0.880-0.990) and 0.854 (95%CI: 0.697-1.000), and the C-indices of the two sets were 0.919 (95%CI: 0.860-0.978) and 0.900 (95%CI: 0.791-1.009). The nomogram demonstrated precise risk prediction of preoperative DVT occurrence in TKA as confirmed by the calibration curve and decision curve analysis.

CONCLUSIONS

This Nomogram demonstrates great differentiation, calibration and clinical validity. By assessing individual risk, clinicians can promptly detect the onset of DVT, facilitating additional life monitoring and necessary medical interventions to prevent the progression of DVT effectively.