入院血清前白蛋白与老年髋部骨折术前深静脉血栓形成的关系：一项回顾性研究

The Association between Admission Serum Prealbumin and Preoperative Deep Venous Thrombosis in Geriatrics Hip Fracture: A Retrospective Study

摘要: 目的：本研究旨在评估血清前白蛋白水平与老年髋部骨折患者术前深静脉血栓形成(DVT)之间的关系。方法：我们对1819例在西北地区最大的创伤中心接受手术治疗的髋部骨折患者进行了回顾性队列研究。所有患者术前均行血常规检查。使用双下肢静脉超声诊断DVT。根据前白蛋白水平将患者分为5组。我们使用三种不同的模型进行了单变量和多变量二元逻辑回归模型，以检验前白蛋白水平与术前DVT之间的相关性。应用统计软件包R和EmpowerStats进行了所有分析。结果：共1819例患者根据血清前白蛋白水平分为五组。共有580例患者(31.89%)被诊断为术前DVT。在单变量分析中，我们发现了性别、骨折分类、多发伤、手术时间和痴呆等潜在混杂因素。二元逻辑回归分析显示，前白蛋白水平与DVT风险呈正相关，控制混杂因素后，前白蛋白浓度每增加10 mg/L，DVT风险降低3% (OR = 0.97, 95%CI: 0.95~0.99, P = 0.0135)。结论：血清前白蛋白水平与老年髋部骨折患者术前DVT相关，可作为DVT风险的预测因子。

Abstract: Objective: This study aimed to evaluate the association between serum prealbumin levels and preoperative deep vein thrombosis (DVT) in geriatric patients with hip fractures. Methods: We conducted a retrospective cohort study of 1819 patients with hip fractures who had been treated surgically at the largest trauma center in Northwest China. All the patients underwent blood examinations before surgery. DVT was diagnosed using a double lower-limb vein ultrasound. The patients were divided into five groups according to their prealbumin levels. We performed univariate and multivariable binary logistic regression models to test the association between prealbumin level and preoperative DVT using three distinct models. All analyses were performed using statistical software packages R and EmpowerStats. Results: A total of 1819 patients were divided into five groups based on their serum prealbumin levels. In total, 580 patients (31.89%) were diagnosed with preoperative DVT. In univariate analysis, we found potential confounding factors regarding sex, fracture classification, multiple injuries, time to operation, and dementia. The binary logical regression analysis showed that the level of prealbumin was positively associated with DVT risk, and the detailed result showed a DVT risk decrease of 3% (OR = 0.97, 95%CI: 0.95~0.99, P = 0.0135) when prealbumin concentration increased by 10 mg/L after controlling for confounding factors. Conclusion: Serum prealbumin level is associated with preoperative DVT in geriatric patients with hip fractures and could be considered a predictor of DVT risk.