The TAT/PIC ratio on postoperative day 6 was significantly increased in patients with VTE (P < .0001), showing an AUC of 0.78 and a negative predictive value of 94.12%.
Cohort (n=83)
Do coagulation and fibrinolysis markers predict postoperative venous thromboembolism in patients undergoing total joint arthroplasty?
The TAT/PIC ratio demonstrates high sensitivity and negative predictive value, making it a potential prognostic biomarker for early postoperative VTE in joint arthroplasty patients.
Effect estimate: AUC 0.78
p-value: p=<.0001
One common complication after joint arthroplasty is venous thromboembolism (VTE). Therefore, it is essential to measure the changes in coagulation and fibrinolysis in order to predict VTE among patients who underwent joint arthroplasty. This study aimed to identify potential useful biomarkers for prognosing to VTE. This was a prospective cohort study enrolling 83 patients who underwent joint arthroplasty. The levels of d-dimer, thrombin–antithrombin complex (TAT), plasmin–α2-antiplasmin complex (PIC), soluble thrombomodulin, and tissue plasminogen activator inhibitor complex were measured on day 0 (before surgery) and days 1, 3, and 6 after surgery. Ultrasound examination was used to diagnose VTE on preoperative day 0 and postoperative day 6. A total of 35 patients developed VTE after surgery. Patients with VTE exhibited significantly higher levels of d-dimer and TAT on postoperative days 3 and 6 (all P < .05). The area under curves (AUC) of receiver operating characteristic (ROC) were 0.65 and 0.68 and 0.68 and 0.74 for d-dimer and TAT levels on postoperative days 3 and 6, respectively. The level of TAT/PIC ratio on postoperative day 6 was significantly increased among patients with VTE compared to non-VTE patients ( P < .0001). In addition, the AUC of ROC, cutoff level, sensitivity, specificity, positive-predictive value, and negative-predictive value of TAT/PIC ratio were 0.78, 4.03 ng/TU, 97.14%, 33.33%, 51.52%, and 94.12%, respectively. The high sensitivity and negative predictive value of TAT/PIC ratio make it a potential prognostic index for diagnosing VTE during the early phase of postoperative joint arthroplasty.
Cheng et al. (Tue,) conducted a cohort in Venous thromboembolism after joint arthroplasty (n=83). Coagulation and fibrinolysis markers (TAT/PIC ratio) was evaluated on Venous thromboembolism (VTE) (AUC 0.78, p=<.0001). The TAT/PIC ratio on postoperative day 6 was significantly increased in patients with VTE (P < .0001), showing an AUC of 0.78 and a negative predictive value of 94.12%.