Research and practice in thrombosis and haemostasis · 2026
Prior intra-articular sodium hyaluronate injection as a novel predictor of isolated distal deep vein thrombosis after knee surgery: development and validation of a 5-factor nomogram.
СтатьяВалидационное исследованиеНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Xie Xiaoguang, Lu Jie, Huang Houmei, Wang Yuerong, Ma Menghui, Lai Mengyun, Liu Jing, Zheng Xiaojing
Аннотация
BACKGROUND: Isolated distal deep vein thrombosis (IDDVT) is a frequent but underrecognized complication after knee surgery. Existing prediction tools rarely target distal thrombosis specifically and often omit key perioperative laboratory, inflammatory, and procedural variables.
OBJECTIVES: The study's objective was to pinpoint independent determinants of postoperative IDDVT and to design a personalized predictive nomogram.
METHODS: This retrospective analysis enrolled 1068 individuals who received knee operations during the period from 2019 to 2024. Demographic characteristics, laboratory biomarkers, inflammatory indices, anesthesia duration, and a history of intra-articular sodium hyaluronate injection were collected. Least absolute shrinkage and selection operator regression identified the relevant predictors, which were then input into a multivariable logistic regression model to produce the final algorithm. Model performance was evaluated through area under the curve (AUC) analysis, bootstrap-based calibration assessment, decision curve analysis, and examination of clinical impact curve.
RESULTS: IDDVT occurred in 84 patients (7.9%). Five variables were independently associated with IDDVT: D-dimer, fasting plasma glucose, neutrophil-to-lymphocyte ratio, anesthesia duration, and prior intra-articular sodium hyaluronate injection. The nomogram demonstrated excellent discrimination (area under the curve, 0.889; 95% CI, 0.851-0.927) and good calibration (Brier score, 0.052; calibration slope, 1.000). Both decision curve analysis and clinical impact curve demonstrated that the model offered substantial net benefit across threshold probabilities ranging from 1% to 74%.
CONCLUSION: We developed and validated a 5-factor nomogram for predicting post-knee surgery IDDVT. Prior sodium hyaluronate injection emerged as a significant predictor, likely as a marker of advanced joint pathology. Further prospective studies are needed to integrate this finding into perioperative risk management.
OBJECTIVES: The study's objective was to pinpoint independent determinants of postoperative IDDVT and to design a personalized predictive nomogram.
METHODS: This retrospective analysis enrolled 1068 individuals who received knee operations during the period from 2019 to 2024. Demographic characteristics, laboratory biomarkers, inflammatory indices, anesthesia duration, and a history of intra-articular sodium hyaluronate injection were collected. Least absolute shrinkage and selection operator regression identified the relevant predictors, which were then input into a multivariable logistic regression model to produce the final algorithm. Model performance was evaluated through area under the curve (AUC) analysis, bootstrap-based calibration assessment, decision curve analysis, and examination of clinical impact curve.
RESULTS: IDDVT occurred in 84 patients (7.9%). Five variables were independently associated with IDDVT: D-dimer, fasting plasma glucose, neutrophil-to-lymphocyte ratio, anesthesia duration, and prior intra-articular sodium hyaluronate injection. The nomogram demonstrated excellent discrimination (area under the curve, 0.889; 95% CI, 0.851-0.927) and good calibration (Brier score, 0.052; calibration slope, 1.000). Both decision curve analysis and clinical impact curve demonstrated that the model offered substantial net benefit across threshold probabilities ranging from 1% to 74%.
CONCLUSION: We developed and validated a 5-factor nomogram for predicting post-knee surgery IDDVT. Prior sodium hyaluronate injection emerged as a significant predictor, likely as a marker of advanced joint pathology. Further prospective studies are needed to integrate this finding into perioperative risk management.