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May 28, 2026Current Problems in Surgery0 citationsOpen Access

A Perioperative Risk Prediction Model for Deep Vein Thrombosis in Hip Fracture Patients Based on Coagulation-Fibrinolysis Biomarkers

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HZHongyi ZhuCentral South UniversityXZXiao ZeSoochow UniversityXZXiao ZhangSoochow University

Key Result

A predictive model incorporating TAT, PIC, t-PAIC, and D-dimer demonstrated good discriminative ability for perioperative deep vein thrombosis in hip fracture patients (AUC 0.829).

Key Points

  • This study aims to assess the effectiveness of a DVT prediction model using coagulation-fibrinolysis biomarkers in hip fracture patients.
  • Conducted a retrospective cohort study of 210 hip fracture patients at the Second Affiliated Hospital of Soochow University.
  • Divided patients into DVT and non-DVT groups based on perioperative Doppler ultrasound findings.
  • Utilized multivariable logistic regression to identify independent DVT risk factors and constructed a predictive model.
  • Identified independent risk factors for DVT: TAT (OR = 1.048), PIC (OR = 1.682), t-PAIC (OR = 1.089), and D-dimer (OR = 1.094), all P < 0.05.
  • The biomarker-based prediction model showed an AUC of 0.829, indicating good discriminative ability.
  • Demonstrated effective risk stratification and potential for individualized anticoagulation strategies.

Study Design

Type

Cohort (n=210)

Multicenter

No

Structured PICO

Can a predictive model incorporating TAT, PIC, t-PAIC, and D-dimer accurately predict perioperative deep vein thrombosis in patients with hip fractures?

P
Population
210 patients with hip fractures admitted to the Second Affiliated Hospital of Soochow University between September 2023 and January 2025
I
Intervention
Perioperative coagulation and fibrinolysis biomarkers (TAT, PIC, t-PAIC, and D-dimer) for DVT risk prediction
O
Outcome
Deep vein thrombosis (DVT) identified by perioperative Doppler ultrasoundhard clinical

A predictive model using coagulation and fibrinolysis biomarkers (TAT, PIC, t-PAIC, and D-dimer) shows good discriminative ability for identifying perioperative DVT risk in hip fracture patients.

Main Result

Effect estimate: AUC 0.829

Abstract

Objective This study aimed to evaluate the clinical utility of a perioperative deep vein thrombosis (DVT) prediction model based on combined coagulation–fibrinolysis biomarkers in patients with hip fractures, with the goal of improving the identification of individuals at high risk for DVT. Methods A retrospective cohort study was conducted including 210 patients with hip fractures admitted to the Second Affiliated Hospital of Soochow University between September 2023 and January 2025. Based on perioperative Doppler ultrasound findings, patients were divided into a DVT group (n = 79) and a non-DVT group (n = 131). Perioperative coagulation and fibrinolysis biomarkers including thrombin–antithrombin complex (TAT), plasmin–α2 inhibitor complex (PIC), thrombomodulin (TM), and tissue-type plasminogen activator inhibitor complex (t-PAIC), along with relevant clinical data, were collected. Independent risk factors for DVT were identified using multivariable logistic regression analysis and incorporated into a predictive model. The predictive performance of the model was evaluated using receiver operating characteristic (ROC) curve analysis, and a nomogram was constructed for risk visualization and clinical application. Results Logistic regression analysis identified TAT (OR = 1.048), PIC (OR = 1.682), t-PAIC (OR = 1.089), and D-dimer (OR = 1.094) as independent risk factors for DVT ( P < 0.05). The combined biomarker-based model demonstrated good discriminative ability, with an area under the ROC curve (AUC) of 0.829. The prediction model demonstrated good calibration, and decision curve analysis indicated a favorable clinical net benefit. Conclusion A predictive model incorporating TAT, PIC, t-PAIC, and D-dimer provides effective risk stratification for perioperative DVT in patients with hip fractures. Dynamic monitoring of these biomarkers may further guide individualized anticoagulation strategies and support clinical decision-making.

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Cite This Study

Zhu et al. (2026) conducted a cohort in hip fractures (n=210). Predictive model incorporating TAT, PIC, t-PAIC, and D-dimer was evaluated on Deep vein thrombosis (DVT) prediction (AUC 0.829). A predictive model incorporating TAT, PIC, t-PAIC, and D-dimer demonstrated good discriminative ability for perioperative deep vein thrombosis in hip fracture patients (AUC 0.829).

synapsesocial.com/papers/6a17da9b3fad632b0f9d79fchttps://doi.org/10.1016/j.cpsurg.2026.102067
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