Establishment and validation of a nomogram predicting the risk of deep vein thrombosis before total knee arthroplasty
Abstract Purpose This study aimed to analyze the independent risk factors contributing to preoperative DVT in TKA and constructed a predictive nomogram to accurately evaluate its occurrence based on these factors. Methods The study encompassed 496 patients who underwent total knee arthroplasty at ou...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2024-02-01
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| Series: | Thrombosis Journal |
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| Online Access: | https://doi.org/10.1186/s12959-024-00588-6 |
| _version_ | 1797273525143207936 |
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| author | Zehua Wang Xingjia Mao Zijian Guo Guoyu Che Changxin Xiang Chuan Xiang |
| author_facet | Zehua Wang Xingjia Mao Zijian Guo Guoyu Che Changxin Xiang Chuan Xiang |
| author_sort | Zehua Wang |
| collection | DOAJ |
| description | Abstract Purpose This study aimed to analyze the independent risk factors contributing to preoperative DVT in TKA and constructed a predictive nomogram to accurately evaluate its occurrence based on these factors. Methods The study encompassed 496 patients who underwent total knee arthroplasty at our hospital between June 2022 and June 2023. The dataset was randomly divided into a training set (n = 348) and a validation set (n = 148) in a 7:3 ratio. The least absolute shrinkage and selection operator (LASSO) and multivariate logistic regression analysis were used to screen the predictors of preoperative DVT occurrence in TKA and construct a nomogram. The performance of the predictive models was evaluated using the concordance index (C-index), calibration curves, and the receiver operating characteristic (ROC) curves. Decision curve analysis was used to analyze the clinical applicability of nomogram. Results A total of 496 patients who underwent TKA were included in this study, of which 28 patients were examined for lower extremity DVT preoperatively. Platelet crit, Platelet distribution width, Procalcitonin, prothrombin time, and D-dimer were predictors of preoperative occurrence of lower extremity DVT in the nomograms of the TKA patients. In addition, the areas under the curve of the ROC of the training and validation sets were 0.935 (95%CI: 0.880–0.990) and 0.854 (95%CI: 0.697-1.000), and the C-indices of the two sets were 0.919 (95%CI: 0.860–0.978) and 0.900 (95%CI: 0.791–1.009). The nomogram demonstrated precise risk prediction of preoperative DVT occurrence in TKA as confirmed by the calibration curve and decision curve analysis. Conclusions This Nomogram demonstrates great differentiation, calibration and clinical validity. By assessing individual risk, clinicians can promptly detect the onset of DVT, facilitating additional life monitoring and necessary medical interventions to prevent the progression of DVT effectively. |
| first_indexed | 2024-03-07T14:45:37Z |
| format | Article |
| id | doaj.art-571467a71b8246cda04075aff2176499 |
| institution | Directory Open Access Journal |
| issn | 1477-9560 |
| language | English |
| last_indexed | 2024-03-07T14:45:37Z |
| publishDate | 2024-02-01 |
| publisher | BMC |
| record_format | Article |
| series | Thrombosis Journal |
| spelling | doaj.art-571467a71b8246cda04075aff21764992024-03-05T20:00:15ZengBMCThrombosis Journal1477-95602024-02-0122111610.1186/s12959-024-00588-6Establishment and validation of a nomogram predicting the risk of deep vein thrombosis before total knee arthroplastyZehua Wang0Xingjia Mao1Zijian Guo2Guoyu Che3Changxin Xiang4Chuan Xiang5Department of Orthopedic, The Second Hospital of Shanxi Medical UniversityDepartment of Basic Medicine Sciences, and Department of Orthopaedics of Sir Run Run Shaw Hospital, Zhejiang University School of MedicineDepartment of Orthopedic, The Second Hospital of Shanxi Medical UniversitySchool of Health, Yuncheng Vocational and Technical UniversityCollege of Biomedical Engineering, Taiyuan University of TechnologyDepartment of Orthopedic, The Second Hospital of Shanxi Medical UniversityAbstract Purpose This study aimed to analyze the independent risk factors contributing to preoperative DVT in TKA and constructed a predictive nomogram to accurately evaluate its occurrence based on these factors. Methods The study encompassed 496 patients who underwent total knee arthroplasty at our hospital between June 2022 and June 2023. The dataset was randomly divided into a training set (n = 348) and a validation set (n = 148) in a 7:3 ratio. The least absolute shrinkage and selection operator (LASSO) and multivariate logistic regression analysis were used to screen the predictors of preoperative DVT occurrence in TKA and construct a nomogram. The performance of the predictive models was evaluated using the concordance index (C-index), calibration curves, and the receiver operating characteristic (ROC) curves. Decision curve analysis was used to analyze the clinical applicability of nomogram. Results A total of 496 patients who underwent TKA were included in this study, of which 28 patients were examined for lower extremity DVT preoperatively. Platelet crit, Platelet distribution width, Procalcitonin, prothrombin time, and D-dimer were predictors of preoperative occurrence of lower extremity DVT in the nomograms of the TKA patients. In addition, the areas under the curve of the ROC of the training and validation sets were 0.935 (95%CI: 0.880–0.990) and 0.854 (95%CI: 0.697-1.000), and the C-indices of the two sets were 0.919 (95%CI: 0.860–0.978) and 0.900 (95%CI: 0.791–1.009). The nomogram demonstrated precise risk prediction of preoperative DVT occurrence in TKA as confirmed by the calibration curve and decision curve analysis. Conclusions This Nomogram demonstrates great differentiation, calibration and clinical validity. By assessing individual risk, clinicians can promptly detect the onset of DVT, facilitating additional life monitoring and necessary medical interventions to prevent the progression of DVT effectively.https://doi.org/10.1186/s12959-024-00588-6Total knee arthroplastyPreoperative deep vein thrombosisNomogram |
| spellingShingle | Zehua Wang Xingjia Mao Zijian Guo Guoyu Che Changxin Xiang Chuan Xiang Establishment and validation of a nomogram predicting the risk of deep vein thrombosis before total knee arthroplasty Thrombosis Journal Total knee arthroplasty Preoperative deep vein thrombosis Nomogram |
| title | Establishment and validation of a nomogram predicting the risk of deep vein thrombosis before total knee arthroplasty |
| title_full | Establishment and validation of a nomogram predicting the risk of deep vein thrombosis before total knee arthroplasty |
| title_fullStr | Establishment and validation of a nomogram predicting the risk of deep vein thrombosis before total knee arthroplasty |
| title_full_unstemmed | Establishment and validation of a nomogram predicting the risk of deep vein thrombosis before total knee arthroplasty |
| title_short | Establishment and validation of a nomogram predicting the risk of deep vein thrombosis before total knee arthroplasty |
| title_sort | establishment and validation of a nomogram predicting the risk of deep vein thrombosis before total knee arthroplasty |
| topic | Total knee arthroplasty Preoperative deep vein thrombosis Nomogram |
| url | https://doi.org/10.1186/s12959-024-00588-6 |
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