No abstract

Purpose To investigate the association of red blood cell (RBC), hemoglobin (Hb), red cell distribution width-coefficient of variation (RDW-CV), and red cell distribution width-standard deviation (RDW-SD) with preoperative deep vein thrombosis (DVT) in patients undergoing total joint arthroplasty (TJA). Methods A total of 2059 TJA patients were enrolled. We used the ratios of RBC, Hb, RDW-CV, and RDW-SD to DVT before TJA to create the receiver operator characteristic (ROC) curve, thereby calculating the cut-off values and the area under the curve (AUC). The patients were categorized into groups based on cut-off value, and risk factors for DVT before TJA were subsequently analyzed. We included the variates that were statistically significant in the univariate analysis in the multivariate binary logistic regression analysis. Results Preoperative DVT occurred in 107 cases (5.20%). Based on the ROC curve, we found that the AUC for RBC, Hb, RDW-CV, and RDW-SD were 0.658, 0.646, 0.568, and 0.586, respectively. Multivariate binary regression analysis revealed that the risk of preoperative DVT in TJA patients with RBC≤3.92*109 /L, Hb≤118g/L, RDW-CV≥13.2%, and RDW-SD≥44.6fL increased 3.02 ( P < 0.001, 95% confidence interval (CI) [2.0–4.54]), 2.15 ( P < 0.001, 95% CI [1.42–3.24]), 1.54 ( P = 0.038, 95% CI [1.03–2.3]), and 1.98 times ( P = 0.001, 95% CI [1.32–2.98]), respectively. The risk of preoperative DVT in patients with corticosteroid use increased approximately 2.6 times ( P = 0.002, 95% CI [1.22–5.81]). Conclusion We found that decreased RBC and Hb, increased RDW-CV and RDW-SD, and corticosteroid use were independent risk factors for preoperative DVT in patients undergoing TJA.

To investigate the association between albumin and preoperative deep vein thrombosis (DVT) in patients undergoing total joint arthroplasty (TJA). This study enrolled 2133 patients. We created the receiver operator characteristic curve to determine the cut-off values for preoperative albumin (bromocresol green method) and DVT in TJA patients. We divided the patients into groups based on the albumin cut-off value and then assessed the risk factors in a multivariate logistic regression analysis. DVT occurred in 110 cases. The cut-off value for albumin was 37.2 g/L and the area under the curve was 0.611. Multivariate logistic regression analysis revealed that the risk for DVT before TJA in patients with albumin <37.2 g/L was increased by 1.99 times ( P = .001, 95% confidence interval [CI] [1.34-2.97]); albumin of 30 to 37.2 g/L group and the albumin < 30 g/L group increased by 1.9 times ( P = .002, 95% CI [1.28-2.88]) and 3.25 times ( P = .015, 95% CI [1.26-8.4]), respectively. The patients in the albumin of 30 to 37.2 g/L and the albumin < 30 g/L group had 1.6 times ( P < .001, 95% CI [1.3-1.99] and 6.1 times ( P < .001, 95% CI [3.46-10.75]), respectively, higher risk of perioperative transfusion. Patients older than 69.5 years had a 3.8-fold increased risk of preoperative DVT ( P = .005, 95% CI [2.47-5.78]). Corticosteroid use had a 3 times higher risk of preoperative DVT ( P = .013, 95% CI [1.26-7.2]). We found that albumin < 37.2 g/L, patients older than 69.5 years, and corticosteroid use were independent risk factors for preoperative DVT in TJA patients. Additionally, the lower the preoperative albumin level, the greater the odds of preoperative DVT formation, and the higher the risk of perioperative transfusion.

Background Preoperative anemia is a common complication in knee osteoarthritis (KOA) patients. However, the association between anemia and preoperative deep vein thrombosis (DVT) in osteoarthritis patients remains unknown. The aim of this study was to investigate such association. Methods In this retrospective study, we included 1005 KOA patients undergoing total knee arthroplasty (TKA) in our hospital. According to preoperative hemoglobin levels, the patients were divided into anemia group and non-anemia group. According to the results of Doppler ultrasonography for the lower extremities, the patients were divided into DVT group and non-DVT group. A logistic model was established through propensity score matching (PSM), with anemia before TKA as the dependent variable, DVT-related variable as the covariate, and 0.03 as the Caliper value. The anemia group and non-anemia group were matched at a 1:1 ratio and 310 successfully matched. After matching, logistic regression analysis was used to evaluate the correlation between preoperative anemia and DVT in KOA patients. Results In this study, 342 cases (33.6%) had preoperative anemia and 73 cases (7.2%) had DVT before TKA. After matching, 46 DVT cases (7.42%) were found. By using binary logistic regression after PSM, we found that the risk for preoperative DVT formation in TKA patients with preoperative anemia increased by 1.97 times [95% (CI 1.05–3.69)], P = 0.035. Conclusion Preoperative anemia is considered as an independent risk factor for the formation of preoperative DVT in KOA patients. Trial registration: ChiCRT2100054844.