Risk Of Deep Vein Thrombosis Research Articles

Anatomical insights into the median septum on soleal vein network and deep vein thrombosis risk

Anatomical insights into the median septum on soleal vein network and deep vein thrombosis risk

Meta-Analysis Investigating Optimal Timing of Chemoprophylaxis for Venous Thromboembolism in Operatively Managed Blunt Spinal Injuries.

Blunt spinal injuries (BSIs) are associated with substantial morbidity and mortality. Management typically involves stabilization of the spinal column and may include chemoprophylaxis for venous thromboembolism (VTE) prevention. The optimal timing of chemoprophylaxis initiation in operatively managed BSI patients remains debated. Analyze available literature on optimal chemoprophylaxis timing for the prevention of VTE in patients postinjury undergoing operative repair. Systematic review and meta-analysis. A systematic review and meta-analysis were conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. PubMed and MEDLINE were searched for studies assessing chemoprophylaxis timing in adult BSI patients. Inclusion criteria focused on operatively managed BSIs and anticoagulant usage assessment. Three studies involving 4345 patients were included. Early chemoprophylaxis initiation was associated with significantly lower deep vein thrombosis (DVT) and overall VTE incidence compared with late initiation. No significant differences were found in pulmonary embolism (PE) incidence or mortality. Early anticoagulant administration after spinal fixation for BSI reduces DVT and overall VTE risk without impacting PE incidence or mortality. Further research is recommended to solidify these findings and address existing gaps in the literature. Early chemoprophylaxis initiation in operatively managed BSI patients reduces DVT and overall VTE risk without affecting PE incidence or mortality LEVEL OF EVIDENCE: 2.

Effect of muscle strength on deep vein thrombosis: A Mendelian randomization study.

Deep vein thrombosis (DVT) is a serious condition characterized by blood clots in deep veins, posing a significant public health burden. Muscle strength has been implicated as a potential risk factor for DVT due to its influence on venous return. This study aims to investigate the causal association between muscle strength and DVT using a Mendelian randomization (MR) approach, leveraging genetic variants as instrumental variables (IVs). We conducted a 2-sample MR analysis using genome-wide association study (GWAS) data for hand-grip strength and DVT. IVs were selected based on their significant associations with muscle strength and DVT, as well as their linkage disequilibrium patterns. We employed statistical methods including inverse-variance weighting (IVW), MR-Egger, and weighted median to address pleiotropy bias. Sensitivity analyses were conducted to evaluate the robustness of the results. A total of 21 and 14 independent IVs were identified for hand grip strength (EWGSOP) and hand grip strength (FNIH), respectively. IVW analysis revealed a consistent causal and negative association between both definitions of hand grip strength and DVT (EWGSOP: OR = 0.702, 95% CI: 0.511-0.964, P = .029; FNIH: OR = 0.715, 95% CI: 0.570-0.898, P = .004). No directional pleiotropy was detected in MR-Egger and MR-PRESSO analyses for either definition (EWGSOP: MR-Egger Intercept P = .516; MR-PRESSO global test P = .162; FNIH: MR-Egger Intercept P = .569; MR-PRESSO global test P = .371).Sensitivity analyses demonstrated the stability of the causal effect estimates, with little influence from individual IVs. The MR analysis provided evidence of a causal association between muscle strength and DVT risk, suggesting that increasing muscle strength may have a protective effect. These findings have implications for preventive strategies and the promotion of resistance exercises and muscle-strengthening activities. Further research and validation of these results could inform clinical guidelines and interventions for DVT prevention.

Rescue of COVID-19 Patient Complicated by Spontaneous Pneumothorax and Acute Pulmonary Thromboembolism

Abstract Pulmonary thromboembolism is a common cardiovascular disease, with high morbidity and mortality rates in hospitalized patients. Because of clotting disorders and hypoxemia caused by COVID-19, critically ill patients are highly susceptible to thrombotic complications. A study published in the Journal of the American Medical Association in 2022 showed that the incidence of venous thromboembolism (VTE) in critically ill COVID-19 patients was approximately 10% to 35%, whereas the incidence of VTE in autopsy cases was as high as 60% (JAMA Intern Med 182:1063-1070). Clinicians need increased awareness of VTE in COVID-19 patients, to reduce the risk of deep vein thrombosis and pulmonary thromboembolism and to be alert to life-threatening complications.

Glucagon-like Peptide-1 Receptor Agonist Use is Associated With Increased Risk of Perioperative Complication and Readmission Following Shoulder Arthroplasty

Glucagon-like peptide-1 (GLP-1) receptor agonists, increasingly used for diabetes management and weight loss, have been linked to lower readmission rates after knee and hip arthroplasty. However, their impact on total shoulder arthroplasty (TSA) outcomes remains unclear. This study investigates the effects of GLP-1 receptor agonists on major complications and revisions following TSA. A retrospective query of the TriNetX database from 2010 to 2023 was performed to identify patients who underwent anatomic or reverse TSA and were prescribed GLP-1 receptor agonists. GLP-1 receptor agonist users were 1:1 propensity score-matched to controls for demographic factors and comorbidities, yielding 1,259 patients in each group. Outcomes included 90-day postoperative medical complications and readmission and revision surgery at 2 years. Odds ratios (ORs), 95% confidence intervals, and P values were calculated. After Bonferroni correction, P < 0.005 was considered significant. GLP-1 receptor agonist users (n = 1,259) experienced significantly higher rates of deep vein thrombosis (1.6% vs. 0.9%; OR 3.0; P = 0.001), myocardial infarction (1.60% vs. 0.9%; OR 2.84; P = 0.003), pneumonia (3.34% vs 1.50%; OR 2.25; P = 0.003), transfusion (7.1% vs. 4.3%; OR 1.7; P = 0.003), and readmission (8.1% vs 5.2%; OR 1.6; P = 0.004) in the 90-day postoperative period compared to patients not taking GLP-1 receptor agonists. There were no differences in the rates of stroke, pulmonary embolism, postoperative anemia, or renal failure. In patients with a minimum 2-year follow-up (n = 776), there was no difference in revision rate (3.2% vs 1.8%; OR 1.8; P = 0.07). GLP-1 receptor agonist use during TSA was associated with an increased risk of deep vein thrombosis, myocardial infarction, pneumonia, need for transfusion, and readmission. Further investigation into the perioperative risk assessment and medical optimization of patients utilizing GLP-1 receptor agonists may be warranted.

Lipoprotein(a) levels in patients with cryptogenic stroke and persistent foramen ovale

Abstract Background Elevated levels of lipoprotein(a) [Lp(a)] are an independent risk factor for the development of atherosclerotic cardiovascular disease (ASCVD). However, it is not known whether high Lp(a) is associated with cryptogenic stroke. Methods We included 478 patients with cryptogenic stroke that underwent closure of a persistent foramen ovale and had Lp(a) measurement available. These patients were matched according to age and gender in a 1:3 ratio to 1434 controls. Results Mean age of patients was 49.9 +/-12.9 years and 275 patients (57.4%) were male. Median Lp(a) levels were significantly higher in cases (26 IQR 13 – 87 nmol/L) as compared to controls (16 IQR 2 – 61 nmol/L; p&amp;lt;0.00001). Lp(a) levels &amp;gt; 200 nmol/L were significantly more frequent in patients with cryptogenic stroke as compared to controls (10.0 % vs. 7.0 %; p&amp;lt;0.05). The odds-ratio for an increase of Lp(a) by 50nmol/L was 1.09 (95% CI 1.03 – 1.15) independent of age and gender. Conclusion Patients with cryptogenic stroke and persistent foramen ovale showed significantly higher plasma levels of Lp(a) and an increase of Lp(a) was associated with a significant increased risk for cryptogenic stroke. Whether high Lp(a) increases risk for deep vein thrombosis leading to embolization or for arterial thrombosis has to be elucidated in further studies.

Influence of Diabetes Mellitus on Postoperative Complications After Total Knee Arthroplasty: A Systematic Review and Meta-Analysis

Background and Objectives: Total knee arthroplasty (TKA) is an effective treatment option for severe knee osteoarthritis. Understanding the impact of diabetes mellitus (DM) on postoperative outcomes is crucial for improving patient satisfaction after TKA. This study aimed to investigate the influence of DM on postoperative complications and mortality after TKA. Materials and Methods: We conducted a systematic review and meta-analysis by searching relevant studies published before December 2023 in the PubMed, EMBASE, Cochrane Library, Medline, and Web of Science databases. The assessment included demographic data, comorbidities, and postoperative complications after primary TKA for both DM and non-DM patients. The odds ratio (OR) was used to represent the estimate of risk of a specific outcome. Results: Thirty-nine studies were finally included in this meta-analysis. Patients with DM had higher rates of periprosthetic joint infection (OR: 1.71, 95% confidence interval [CI]: 1.46–2.00, p &lt; 0.01) and prosthesis revision (OR: 1.37, 95% CI: 1.23–1.52, p &lt; 0.01). Moreover, patients with DM showed an elevated incidence of pneumonia (OR: 1.54, 95% CI: 1.15–2.07, p &lt; 0.01), urinary tract infection (OR: 1.86, 95% CI: 1.07–3.26, p = 0.02), and sepsis (OR: 1.61, 95% CI: 1.46–1.78, p &lt; 0.01). Additionally, the postoperative risk of cardiovascular (OR: 2.49, 95% CI: 1.50–4.17, p &lt; 0.01) and cerebrovascular (OR: 2.38, 95% CI: 1.48–3.81, p &lt; 0.01) events was notably higher in patients with DM. The presence of DM increased the risk of deep vein thrombosis (OR: 1.58, 95% CI: 1.22–2.04, p &lt; 0.01), but did not lead to an increased risk of pulmonary embolism. Most importantly, DM was associated with a higher mortality rate within 30 days after TKA (OR: 1.27, 95% CI: 1.02–1.60, p = 0.03). Conclusions: Patients with DM exhibited a higher rate of postoperative complications after TKA, and DM was associated with a higher mortality rate within 30 days after TKA. It is crucial to educate patients about the perioperative risk and develop evidence-based guidelines to prevent complications after TKA.

Can calf massage prevent deep vein thrombosis? A systematic review

Background: Deep vein thrombosis (DVT) is a condition in which blood clots form in deep veins, usually in the legs. The causes of thrombosis are divided into two, namely those related to immobilization and those related to hypercoagulation, both of which are related to genetic factors and acquired risk factors. DVT can be prevented by preventing recurrent DVT, patients must continue to exercise, and provide compression therapy and anticoagulation therapy with the right duration. Purpose: To evaluate the efficacy of calf massage techniques in lowering the risk of deep vein thrombosis (DVT). Method: The research design used is a systematic review method with article selection referring to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The article search stage is carried out systematically using keywords written manually or using the search facility available in each database. The keywords used in the article search are (massage OR therapy OR pressure) AND (calf OR foot) AND (Deep Vein Thrombosis (DVT)). Article searches are carried out electronically to filter relevant articles. Articles are sourced from the Google Scholar, PubMed, Science Direct, and ProQuest database search engines. The inclusion criteria for this literature review were articles published in the last ten years, namely 2013-2023, articles in Indonesian and English, interventions given to patients at risk of deep vein thrombosis (DVT), interventions using calf massage either with or without tools, randomized controlled trials, experimental/quasi-experimental, and full manuscripts available. Results: Calf massage has been shown to be effective in reducing the risk of deep vein thrombosis (DVT). This is shown based on five journals that have been analyzed that there is a significant decrease in the risk of DVT in the results of the experimental group with the control group and there is only one journal that states that the use of foot pumps does not significantly reduce the incidence of DVT in patients undergoing total knee arthroplasty (TKA) with edoxaban thromboprophylaxis. Conclusion: Massage interventions carried out using tools or without tools with various versions and methods have a positive impact on reducing the risk of DVT.

Feasibility and safety of two weeks of blood flow restriction exercise in individuals with spinal cord injury

Context Reduced muscle strength and function are common after spinal cord injury (SCI). While low-load blood flow restriction exercise (BFRE) enhances muscle strength in healthy and clinical populations, its safety and feasibility in individuals with SCI remain underexplored. Objectives To investigate the feasibility and safety of low-load BFRE in individuals with incomplete SCI. Study Design Case series. Setting SCI rehabilitation center. Participants Six participants with motor incomplete SCI were enrolled in the study. Intervention A two-week BFRE intervention for the lower limbs was conducted twice weekly at 40% total arterial occlusion pressure, using 30-40% of 1-repetition maximum loads. Outcome Measures Feasibility measures, specifically recruitment and eligibility rates and intervention acceptability, were collected. Blood pressure (BP) responses and specific coagulation markers for deep vein thrombosis (DVT) were assessed as safety measures. Results Recruitment and eligibility rates were 2.8% and 6.6% for individuals admitted for first-time rehabilitation (subacute SCI) and 8.3% and 13.9% for 4-week readmission rehabilitation stays (chronic SCI), respectively. Intervention acceptability was high, characterized by 95.8% training adherence and low-to-moderate self-reported pain levels. BP responses and changes in C-reactive protein, Fibrinogen, and D-dimer during the intervention remained within clinically acceptable levels. Conclusion BFRE was feasible in an SCI rehabilitation setting despite a low recruitment rate. BFRE imposed no heightened risk of DVT or severe BP fluctuations in the present case series. Additionally, no severe adverse events occurred, and only mild complaints were reported. More extensive safety considerations warrant larger-scale exploration. Trial registration ClinicalTrials.gov identifier: NCT03690700.

Application of Nursing Project Management in Increasing the Utilization of GCS in Patients at High Risk for DVT

&amp;lt;i&amp;gt;Objective&amp;lt;/i&amp;gt;: To investigate the effect of nursing program improvements on improving the utilization rate of gradient compression stockings in patients at high risk of deep vein thrombosis. &amp;lt;i&amp;gt;Methods&amp;lt;/i&amp;gt;: To set up a special project improvement group, determine the topic of special project improvement, set 40 patients with postoperative Caprin score &amp;gt;5 before the implementation of special project improvement activities, i.e., from January to May 2022 in our hospital, as the control group, and 40 patients with postoperative Caprin score &amp;gt;5 after the implementation of special project improvement activities, i.e., from July to November 2022 in our hospital as the experimental group, and count the number of patients using gradient compression stockings to prevent deep vein thrombosis, and investigate the effect of using gradient compression stockings in improving the utilization rate of patients with high risk of deep vein thrombosis. The number of patients using gradient compression stockings to prevent deep vein thrombosis, the survey of patients&amp;apos; knowledge about deep vein thrombosis and satisfaction with care, and the comparison of the differences between the two groups before and after the project improvement. &amp;lt;i&amp;gt;Results&amp;lt;/i&amp;gt;: The use rate of gradient compression stockings in the experimental group was 82.5% higher than that of gradient compression stockings in the control group, which was 15%, with statistically significant differences (p &amp;lt; 0.05); the experimental group&amp;apos;s knowledge of DVT was higher than that of the control group, with statistically significant differences (p &amp;lt; 0.05); and the experimental group&amp;apos;s satisfaction with nursing care increased from 91.73 points to 98.75 points, with statistically significant differences (p &amp;lt; 0.05). &amp;lt;i&amp;gt;Conclusion&amp;lt;/i&amp;gt;: Project management can effectively increase the utilization rate of gradient compression stockings for high-risk patients with deep vein thrombosis and improve patients&amp;apos; knowledge of deep vein thrombosis and satisfaction with nursing care.

Factor Xa Inhibitors and Low Molecular Weight Heparins in Perioperative Surgical Thromboprophylaxis: A Network Meta-Analysis.

venous thromboembolism (VTE) prophylaxis is crucial for reducing the risk of deep vein thrombosis (DVT) and pulmonary embolism (PE). This network metaanalysis was carried out to determine the most effective intervention among selective Xa inhibitors and low molecular weight heparins (LMWHs) for perioperative surgical thromboprophylaxis in major abdominal, pelvic, lumbar spine, and lower limb surgeries. A systematic literature search was conducted for randomized controlled trials (RCTs) comparing selective factor Xa inhibitors, LMWHs, and placebo as thromboprophylaxis agents in major abdominal, pelvic, lumbar spine, and lower limb surgeries. A Bayesian network metaanalysis was performed to compare all interventions for the risk of developing DVT, VTE, major VTE, total bleeding, and major bleeding. The surface under the cumulative ranking curves was used to rank all interventions. Of 1788 retrieved references, 42 RCTs comparing 11 anticoagulants were included. As compared to enoxaparin, the risk of DVT was significantly reduced in patients treated with fondaparinux [RR: 0.53 (95% CrI: 0.31, 0.93)] and rivaroxaban [RR: 0.42 (95% CrI: 0.27, 0.64)]; VTE in patients treated with bemiparin [RR: 0.09 (95% CrI: 0, 0.7)], edoxaban [RR: 0.43 (95% CrI: 0.18, 0.96)], fondaparinux [RR: 0.55 (95% CrI: 0.34, 0.91)] and rivaroxaban [RR: 0.56 (95% CrI: 0.34, 0.85)]; major VTE in patients treated with rivaroxaban [RR: 0.26 (95% CrI: 0.11, 0.6)]. According to the surface under the cumulative ranking curves (SUCRA) value, fondaparinux and bemiparin increase the risk of serious bleeding more than other factor Xa inhibitors and LMWHs. Rivaroxaban, fondaparinux, edoxaban, and bemiparin are superior perioperative thromboprophylaxis agents than enoxaparin in major surgeries. Fondaparinux and bemiparin have shown the highest risk of major bleeding compared to other factor Xa inhibitors and LMWHs.

Identifying high-risk groups for deep vein thrombosis after primary total knee arthroplasty using preoperative Caprini scores and D-dimer levels.

Caprini score and D-dimer are well-recognized markers in deep vein thrombosis (DVT) assessment. However, their utility in guiding post-arthroplasty DVT risk is hampered by susceptibility to various post-operative factors, limiting their effectiveness as reminders. Conversely, these markers exhibit greater stability in the pre-operative setting. Despite this, research on the pre-operative predictive value of Caprini score and D-dimer for DVT following primary total knee arthroplasty (TKA) remains scarce. In a retrospective study, we analyzed data from patients who underwent primary TKA, between August 2015 and December 2022. Upon admission, Caprini scores were assessed, and comprehensive blood panels were obtained from fasting blood samples. For all patients, lower limb vascular Doppler ultrasonography was performed pre-operatively to exclude those with pre-existing DVT, and all patients underwent DVT examination again post-operatively. Our study included 2,873 patients, averaging 67.98 ± 7.54years, including 676 men and 2,197 women. In this study, 303 (10.55%) patients developed postoperative DVT, and 57 (1.98%) cases presented with lower limb symptoms. DVT incidence in patients with pre-operative Caprini scores of 1-2 (6.50%), 3 (10.28%), and ≥ 4 (18.05%) showed significant differences (P < 0.05). DVT rates were 14.80% in patients with pre-operative D-dimer levels of ≥ 1mg/L, higher than the 8.98% in those with levels of < 0.5mg/L, and 10.61% in those with levels 0.5-1mg/L (P < 0.05). In patients with Caprini scores of 1-2 and D-dimer levels ≤ 0.5mg/L, the occurrence rate of postoperative DVT was only 5.84%. For patients with Caprini scores ≥ 4 and D-dimer levels ≥ 1.0mg/L, the postoperative DVT occurrence rate soared to 24.81%, with the OR(odds ratio) was 4.744 compared to the former group. Patients with preoperative higher Caprini scores and D-dimer are more likely to develop DVT after TKA. Additionally, those with a preoperative Caprini score ≥ 4 and D-dimer level ≥ 1.0mg/L have a significantly increased risk (24.81%) of developing DVT, identifying them as a high-risk group for DVT following TKA. These findings hold significant value for DVT risk stratification in primary TKA patients and the formulation of preoperative interventions to mitigate the risk of DVT.

Potential causal relationships between blood metabolites, inflammatory cytokines, and venous thromboembolism.

Venous thromboembolism (VTE) is the abnormal coagulation of blood in deep veins, which impairs venous return and includes deep vein thrombosis (DVT) and pulmonary embolism (PE). The incidence of VTE is increasing, leading to severe complications and sequelae. Despite the widespread application of multi-omics analyses in vascular disease research, identifying the specific links between various metabolic products, cytokines, and VTE, as well as their potential mediating roles, requires further validation due to confounding factors. Summary statistics for 1,091 metabolites, 309 metabolite ratios (8,299 individuals), and 41 inflammatory cytokines (8,293 individuals) were obtained from the largest genome-wide association studies (GWAS). Summary statistics for VTE (21,021 cases, 391,160 controls), DVT (6,501 cases, 357,111 controls), and PE (10,046 cases, 401,128 controls) were derived from the FinnGen R10 dataset. We initially examined causal relationships using two-sample MR analysis, followed by Two-step Mendelian Randomization (TSMR) and Multivariable Mendelian Randomization (MVMR) to identify potential mediating mechanisms. We identified causal associations for 78 blood metabolites with VTE, 79 with DVT, and 81 with PE. Among all 41 inflammatory cytokines included, only platelet-derived growth factor BB (PDGF-BB) levels showed a causal relationship with increased risks of VTE, DVT, and PE. MVMR analysis revealed that the associations between glycocholate levels and VTE, DVT, and PE were mediated by PDGF-BB, accounting for 14.54% (p=2.84E-04), 17.10% (p=3.64E-05), and 10.44% (p=1.39E-02), respectively. Furthermore, the associations between dodecanedioate (C12:1-DC) levels and VTE and DVT were also mediated by PDGF-BB, accounting for 12.79% (p=6.10E-04) and 12.17% (p=2.13E-04), respectively. This study reveals significant associations between specific blood metabolites and the risks of VTE, DVT, and PE, with some associations potentially mediated by PDGF-BB.

Feasibility and effectiveness of a foam rolling intervention in pregnant women requiring bed rest for foetal protection: a randomised controlled trial

BackgroundBed rest during pregnancy can lead to reduced physical activity, impairing lower limb venous blood flow and increasing the risk of deep vein thrombosis (DVT) and muscle atrophy. We investigated the clinical efficacy of foam rolling intervention (FRI) in enhancing lower limb venous blood flow, mitigating the risk of DVT and muscle atrophy in pregnant women on bed rest.MethodsThis single-blind, randomised controlled trial enrolled 86 pregnant women with long-term bed rest for foetal protection (≥ 7 days), gestational age ≥ 20 weeks, and maternal age < 40 years. Participants were randomly assigned to a control or experimental group using a random number table. The control group received standard care, whereas the experimental group underwent FRI. Researchers and statisticians were aware of the treatment groups, however, the participants were blinded. Lower limb blood flow velocity, D-dimer levels, incidence of DVT, and the extent of lower limb muscle atrophy were assessed in both groups at baseline and post-intervention (day 7). To account for a 5% attrition rate and potential sampling error, the estimated sample size for each experimental and control group was 40.ResultsBefore the intervention, no significant differences were observed between the experimental and control groups in peak blood flow, mean flow velocity, D-dimer values, or leg circumference (P > 0.05), however, the peak blood velocities of the popliteal veins were significantly higher in the control group (P = 0.031). On the seventh day post-intervention, the experimental group had significantly higher mean and peak blood velocities in femoral and popliteal veins, significantly (P < 0.05), lower mean D-dimer levels (P = 0.035), and a significantly smaller reduction in thigh and calf circumference (P < 0.001). Consequently, the rate of thigh muscle atrophy was significantly slower in the experimental group (P = 0.011).ConclusionsFRI is an effective intervention for improving lower limb venous blood flow, mitigating the risk of DVT and muscle atrophy in pregnant women on bed rest.Trial registrationThis trial was retrospectively registered with the Chinese Clinical Trial Registry on June 18, 2024 (registration number: ChiCTR2400085770).

Aggregate Index of Systemic Inflammation: The Strongest Predictor of In-Hospital Venous Thromboembolism Events among Patients Hospitalized for Trauma or Surgery

BackgroundTo investigate the power of inflammation/immune indices in-hospital deep vein thrombosis (DVT) and any venous thromboembolism event (VTE: DVT + pulmonary emboli; PE) that may occur after trauma or surgery and to identify the strongest predictors. MethodsThis was a retrospective study conducted between January 2020 and December 2022. A total of 216 patients with suspicion of DVT or PE during their hospital stay for trauma or surgery were included in the study. Monocyte-lymphocyte ratio (MLR), neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), systemic inflammatory index (SII), systemic inflammation response index (SIRI), and aggregate index of systemic inflammation (AISI) were calculated. Participants were divided into the following 3 groups: Those without DVT or PE (Control group, n = 70), only DVT (DVT group, n = 71), and both DVT and PE (VTE group, n = 75). ResultsThe median D-dimer, NLR, PLR, MLR, SII, SIRI and AISI values of VTE group were significantly higher than both the control and DVT groups (p< 0.001 for all). The DVT group also had significantly higher values for these parameters compared to controls (p<0.001 for all). All of these indices had significantly high performance to detect DVT or PE (p<0.001 for all). Despite very high performance (some exceeding D-dimer measurement) detected for all examined parameters, AISI was the best predictor in both DVT and VTE (DVT + PE) prediction (AUC = 0.995 and 0.959, respectively) ConclusionThese indices, especially AISI, can play a role in the initial screening and risk stratification of patients at high risk of DVT or VTE after surgery or trauma.

Correlation between common iliac vein geometry and the risk of deep vein thrombosis in patients with May-Thurner syndrome.

May-Thurner syndrome (MTS) is a continuous pathological change of the left common iliac vein intraluminal wall due to compression between the right common iliac artery and a lumbar vertebra, with clinical signs of compromised venous drainage of the left leg, which eventually leads to development of left-sided deep vein thrombosis (DVT). To analyze the correlation between iliac vessel geometry and probability of DVT in patients with MTS. This study consists of two age-matched female groups: DVT (n = 21) and control (n = 28). Iliac vein geometry, including left common iliac vein (LCIV) diameter, percentage of stenosis, angle between LCIV and right common iliac vein (RCIV), tilt angle of each CIV with horizontal line, and crossing angle between right common iliac artery (RCIA) and LCIV, were measured on computed tomography venography (CTV) images. The probability of DVT development was assessed using logistic regression. Comparing the DVT and control groups, the mean LCIV diameter was 2.4 mm and 3.7 mm (P = 0.001), and mean LCIV stenosis was 77.7% and 68.3% (P = 0.001), respectively. After age-adjustment, the odds of left DVT in patients with MTS correlated with LCIV diameter (odds ratio [OR]=0.25, P < 0.001, 95% confidence interval [CI]=0.11-0.54), LCIV stenosis (%) (OR=1.12, P = 0.003, 95% CI=1.04-1.21), LCIV tilt angle (OR=0.95, P < 0.038, 95% CI=0.91-0.99), and angle between two CIVs (OR=1.04, P < 0.039, 95% CI=1.00-1.09). LCIV diameter and percentage of stenosis, LCIV tilt angle, and CIV angle were independent risk factors for the development of DVT in patients with MTS.

Construction and validation of a predictive model for preoperative lower extremity deep vein thrombosis risk in elderly hip fracture patients: An observational study.

The aim of this study was to identify independent risk factors for preoperative lower extremity deep vein thrombosis (DVT) in elderly hip fracture patients and to construct a nomogram prediction model based on them. We collected clinical data from elderly hip fracture patients from Ya'an Hospital of Traditional Chinese Medicine (2021-2023), and used univariate and multivariate logistic regression analyses to identify independent risk factors for preoperative DVT. In this way, a nomogram prediction model was established. In addition, external validation of the model was performed by patient data from Ya'an Mingshan District Hospital of Traditional Chinese Medicine. Receiver operating characteristic curve analysis was used to calculate the area under the curve, and calibration and decision curves were plotted to assess the predictive performance of the model. Of the 223 elderly hip fracture patients, 23 (10.31%) developed DVT of the lower extremities before surgery. A total of 6 variables were identified as independent risk factors for preoperative lower extremity DVT in elderly hip fracture patients by logistic regression analysis: age > 75 years (OR = 1.932; 95% CI: 1.230-3.941), diabetes mellitus (OR = 2.139; 95% CI: 1.149-4.342), and prolonged duration of disease (OR. 2.535; 95% CI: 1.378-4.844), surgical treatment (OR = 1.564; 95% CI: 1.389-3.278), D-dimer > 0.5 mg/L (OR = 3.365; 95% CI: 1.229-7.715) fibrinogen > 4 g/L (OR = 3.473; 95% CI: 1.702-7.078). The constructed nomogram model has high accuracy in predicting the risk of preoperative DVT in elderly hip fracture patients, providing an effective tool for clinicians to identify high-risk patients and implement early intervention.

Incidence, Risk Factors, and Correlation with Caprini Score of Deep Vein Thrombosis After Colpocleisis with/without Concomitant Hysterectomy for Pelvic Organ Prolapse in Elderly Women.

The objective was to investigate the incidence and risk factors of lowerextremity deep vein thrombosis (DVT) in elderly women undergoing colpocleisis for pelvic organ prolapse and to evaluate the predictive efficacy of the Caprini scores. Data from patients who underwent colpocleisis from August 2019 to April 2024 were retrospectively analyzed. The primary endpoint was DVT detected by ultrasonography within 7 days of surgery. Univariate and multivariate logistic regression analyses were applied to identify independent risk factors. Efficacy parameters of the Caprini scores were analyzed and optimal cut-off values were selected. A total of 262 patients were enrolled in the study, of whom 8.4% (22 out of 262) developed DVT postoperatively. After statistical analysis, the duration of menopause, history of inflammatory bowel disease, as well as higher levels of preoperative cholesterol and preoperative D-dimer, were identified as independent risk factors. There was a significant difference in the Caprini scores between the DVT and non-DVT groups (7.27 ± 1.28 vs 6.15 ± 0.80, p < 0.001), and the risk of DVT tended to increase with higher Caprini scores. The best performance was achieved when the threshold for the Caprini score was set to 7, at which point the area under the receiver operating characteristic curve was 0.758, the sensitivity was 0.773, and the specificity was 0.662. There was a strong correlation between the occurrence of DVT after colpocleisis and the Caprini score, with higher Caprini scores indicating a higher risk of postoperative DVT. A significantly increased risk was suggested when this score was ≥ 7.

Inflammatory bowel disease and pulmonary embolism: a nationwide perspective.

To examine the characteristics and outcomes of patients with inflammatory bowel disease (IBD) hospitalized with pulmonary embolism (PE). This cross-sectional observational study analyzed data from the 2016 to 2019 National Inpatient Sample to investigate hospitalizations for PE in the USA, stratified by the presence or absence of IBD. Adult patients were selected using the International Classification of Diseases, Tenth Revision codes for PE, Crohn's disease, and ulcerative colitis. Data on patient demographics, comorbidities, and hospital characteristics were collected. Statistical analysis included univariable and multivariable logistic regression using Stata/BE 17.0, focusing on in-hospital mortality and complications in PE patients with and without IBD. Adjusted odds ratios (aOR) and their corresponding 95% confidence intervals (CI) were calculated when appropriate. PE/IBD group was younger (mean age 58.3 vs. 62.7 years; P < 0.001), had a higher proportion of white patients (81.2% vs. 70.9%; P < 0.001), and had a greater prevalence of chronic liver disease (7.54% vs. 6.02%; P = 0.002) when compared to PE/non-IBD patients. The PE/IBD group had lower prevalence rates of coronary artery disease, congestive heart failure, obesity, chronic obstructive pulmonary disease, hypertension, and diabetes. Regarding primary outcomes, there was no significant difference in in-hospital mortality between the two groups (aOR, 0.92; 95% CI, 0.77-1.09; P = 0.355). However, the IBD/PE group had a higher risk of acute kidney injury, sepsis, septic shock, cardiac arrhythmias, and deep vein thrombosis. As for secondary outcomes, PE/IBD patients had more extended hospital stays and higher healthcare costs compared with PE/non-IBD patients. Hospitalized PE patients with IBD differ demographically and have a different comorbidity profile compared to those without IBD. PE/IBD patients demonstrate greater use of healthcare resources and elevated risk of hospitalization adverse events than PE/non-IBD patients, highlighting the necessity for individualized management approaches in this population.

The Impact of Cardiovascular Disease Gene Polymorphism and Interaction with Homocysteine on Deep Vein Thrombosis.

Deep vein thrombosis (DVT) affects vascular health and can even threaten life; however, its pathogenesis remains unclear. Cardiovascular disease (CVD) and DVT share common risk factors, such as dyslipidemia, aging, etc. We aimed to investigate the loci of published CVD susceptibility genes and their association with environmental factors that might be related to DVT. Genotyping by Kompetitive Allele Specific PCR (KASP), collection of lifestyle information, and determination of blood biochemical markers were performed in 165 DVT cases and 164 controls. The impact of six single nucleotide polymorphisms (SNPs) and additional potential variables on DVT morbidity was evaluated using unconditional logistic regression (ULR). To explore the high-order interactions related to genetics and the body's internal environment exposure that affect DVT, ULR, crossover analysis, and multifactor dimensionality reduction/generalized multifactor dimensionality reduction (MDR/GMDR) were employed. Sensitivity analyses were performed using the EpiR package. The polymorphisms of FGB rs1800790 and PLAT rs2020918 were significantly associated with DVT. The optimum GMDR interaction model for gene-gene (G × G) consisted of THBD rs1042579, PLAT rs2020918, and PON1 rs662. The PLAT rs2020918 and MTHFR rs1801133 polymorphisms together eliminated the maximum entropy by the MDR method. The optimum GMDR interaction model for gene-environment (G × E) consisted of MTHFR rs1801133, FGB rs1800790, PLAT rs2020918, PON1 rs662, and total homocysteine (tHcy). Those with high tHcy levels and three risk genotypes significantly increased the DVT risk. In conclusion, certain CVD-related SNPs and their interactions with tHcy may contribute to DVT. These have implications for investigating DVT etiology and developing preventive treatment plans.