Risk factors for deep vein thrombosis following total hip arthroplasty in elderly patients with femoral neck fractures during winter

Xinnan Ma; Rui Zhang; Yonghou Zhao; Xin Zhang

doi:10.1515/fzm-2025-0017

Abstract：Objective: To investigate the risk factors for deep vein thrombosis (DVT) following total hip arthroplasty in elderly patients with femoral neck fractures during the winter. Methods: A total of 162 patients who underwent total hip arthroplasty were categorized based on the development of DVT within 7 days postoperatively: 28 patients formed the DVT group and 134 patients the non-DVT group. Collected data included age, gender, history of glucocorticoid use, diabetes, hypertension, body mass index (BMI), triglyceride (TG) levels, cholesterol (CHOL) levels at admission, operative time, and postoperative bed rest duration. D-dimer (D-D) and fibrinogen (Fg) levels, along with the D-D/Fg ratio, were recorded on the first postoperative day. Group comparisons were performed using t-tests. Logistic regression analysis was conducted to identify independent risk factors, and the predictive value of these factors was evaluated using receiver operating characteristic (ROC) curve analysis. Results: In the DVT group, 18 patients had diabetes. Levels of TG (1.78±0.44 mmol/L), CHOL (4.70±1.84 mmol/L), D-D (0.40±0.17 mg/L), and the D-D/Fg ratio (0.24±0.07) were significantly higher than in the non-DVT group (P<0.05). Logistic regression identified TG, CHOL, D-D, and the D-D/Fg ratio as independent risk factors for DVT, with odds ratios of 0.987, 2.395, 0.8, 4.992, and 9.004, respectively (P<0.05). ROC curve analysis yielded areas under the curve (AUCs) of 0.715, 0.69, 0.614, and 0.726 for TG, CHOL, D-D, and the D-D/Fg ratio, respectively. Sensitivities were 0.643, 0.500, 0.429, and 0.857, and specificities were 0.694, 0.978, 0.918, and 0.537, respectively. Conclusion: Elevated levels of TG, CHOL, D-D, and the D-D/Fg ratio are independent risk factors for DVT following total hip arthroplasty in elderly patients. Among these, the D-D/Fg ratio demonstrated the highest sensitivity and may serve as an effective marker for early-stage DVT screening.