Wenbin Lu,* Fan Jia,* Miaomiao Rao, Wubin Chen, Yi Liu, Jinjun Bian

Faculty of Anesthesiology, Changhai Hospital, Naval Military Medical University, Shanghai, 200433, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Yi Liu, Faculty of Anesthesiology, Changhai Hospital, Naval Military Medical University, 168, Changhai Road, Shanghai, 200433, People’s Republic of China, Tel +86-021-31161837, Fax +86-021-31161837, Email ziboliuyi@yeah.net Jinjun Bian, Faculty of Anesthesiology, Changhai Hospital, Naval Military Medical University, 168, Changhai Road, Shanghai, 200433, People’s Republic of China, Tel +86-021-31161841, +86-021-31161841, Email jinjunbicu@163.com

Objective: This study aimed to explore the potential value of the d-dimer to albumin ratio (DAR) combined with the neutrophil-to-lymphocyte ratio (NLR) for predicting preoperative lower extremity deep vein thrombosis (DVT) in older patients with hip fracture.
Methods: Demographic characteristics, comorbidities, medication history, and preoperative laboratory test results were collected from older patients with hip fracture between 2018 and 2023. Binary logistic regression analysis was used to assess the association between the DAR, NLR, and DVT. Receiver operating characteristic (ROC) curve analysis was performed to calculate the potential value of DAR combined with NLR in predicting preoperative DVT.
Results: A total of 1177 patients were included, of whom 23 (2%) developed lower extremity DVT before surgery. Multivariate logistic regression analysis indicated that age (OR = 1.08, 95% CI = 1.01~1.15, P = 0.015), DAR (OR = 1.53, 95% CI = 1.21~1.92, P < 0.001), and NLR (OR = 1.24, 95% CI = 1.10~1.39, P < 0.001) were independently associated with preoperative DVT in older patients with hip fractures. Furthermore, the ROC curve analysis indicated that DAR combined with NLR has a significant predictive value for DVT, with an area under the curve of 78.72% (95% CI = 68.24– 89.20%).
Conclusion: The preoperative DAR and NLR were independently associated with preoperative DVT in older patients with hip fractures. DAR combined with NLR can be considered as a predictive indicator of DVT.

Keywords: aged, hip fracture, deep vein thrombosis, d-dimer to albumin ratio, neutrophil to lymphocyte ratio