Evaluating preoperative risk factors for deep vein thrombosis in elderly patients with hip fractures and chronic kidney disease: a retrospective study.

BACKGROUND

Deep vein thrombosis (DVT) represents a significant and potentially lethal complication in bedridden elderly inpatients, leading to severe disability and mortality.

PURPOSE: This study aimed to identify determinants contributing to DVT incidence in elderly patients with concurrent hip fractures and chronic kidney disease (CKD).

METHODS

We collected comprehensive data from elderly patients diagnosed with hip fractures and CKD at our hospital between November 2015 and January 2023. Patients were categorized into DVT and non-DVT groups. We conducted detailed demographic, comorbidity, and laboratory analyses using univariate and logistic regression methods. Receiver-operating characteristic (ROC) curves were utilized to establish critical thresholds for predictive variables.

RESULTS

The study revealed a 34.4% DVT rate among 180 patients. Univariate analysis identified significant associations between DVT and older age (p = 0.031), elevated white blood cell (WBC) count (p = 0.005), prolonged thrombin time (TT) (p = 0.030), and increased D-dimer levels (p < 0.001). Logistic regression showed that age (p = 0.009, odds ratio [OR] = 1.049), WBC count (p = 0.001, OR = 1.131), and D-dimer levels (p = 0.010, OR = 1.190) were independent predictors of DVT. ROC analysis established critical thresholds: age (73 years), D-dimer (3.3 ng/mL), and WBC count (9.5 × 10^9/μL).

CONCLUSIONS

Age, D-dimer, and WBC levels independently predict DVT in elderly patients with hip fractures and CKD. Precise thresholds facilitate personalized DVT risk assessment, enabling early and targeted interventions.