Association Between Platelet Indices and Preoperative Deep Vein Thrombosis in Elderly Patients Undergoing Total Joint Arthroplasty: A Retrospective Study

To investigate the association between platelet (PLT) indices and preoperative deep vein thrombosis (DVT) in elderly patients undergoing total joint arthroplasty (TJA). A total of 1391 patients were enrolled. We created receiver operator characteristic (ROC) curve using the ratio of PLT indices to D...

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Published in:Clinical and applied thrombosis/hemostasis 2023-01, Vol.29, p.10760296221149699
Main Authors: Xiong, Xiaojuan, Li, Ting, Yu, Shuang, Cheng, Bo
Format: Article
Language:English
Subjects:
Adrenal Cortex Hormones
Aged
Arthroplasty
Blood Platelets
Health risks
Humans
Joint surgery
Mean Platelet Volume
Older people
Original Manuscript
Perioperative care
Platelet Count
Regression analysis
Retrospective Studies
Steroids
Thrombosis
Venous Thrombosis - etiology
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Li, Ting
Yu, Shuang
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description To investigate the association between platelet (PLT) indices and preoperative deep vein thrombosis (DVT) in elderly patients undergoing total joint arthroplasty (TJA). A total of 1391 patients were enrolled. We created receiver operator characteristic (ROC) curve using the ratio of PLT indices to DVT before TJA, divided the enrolled patients into groups based on the cut-off value, and then analyzed risk factors for DVT before TJA in the multivariate binary logistic regression analysis. Preoperative DVT occurred in 103 cases. Based on the ROC curve, we determined that the cut-off values for PLT, mean platelet volume (MPV), platelet distribution width (PDW), platelet large cell ratio (P-LCR), and plateletcrit (PCT) were 202 × 109/L, 11.4 fL, 13.2 fL, 34.6%, and 0.228%. And the areas under the curve were 0.606, 0.605, 0.617, 0.616, and 0.598. Multivariate binary regression analysis revealed that the risk of preoperative DVT in TJA patients with PLT≥202 × 109/L, MPV≤11.4 fL, PDW≤13.2 fL, P-LCR≤34.6%, and PCT≥0.228% increased by 2.32 (P 
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A total of 1391 patients were enrolled. We created receiver operator characteristic (ROC) curve using the ratio of PLT indices to DVT before TJA, divided the enrolled patients into groups based on the cut-off value, and then analyzed risk factors for DVT before TJA in the multivariate binary logistic regression analysis. Preoperative DVT occurred in 103 cases. Based on the ROC curve, we determined that the cut-off values for PLT, mean platelet volume (MPV), platelet distribution width (PDW), platelet large cell ratio (P-LCR), and plateletcrit (PCT) were 202 × 109/L, 11.4 fL, 13.2 fL, 34.6%, and 0.228%. And the areas under the curve were 0.606, 0.605, 0.617, 0.616, and 0.598. Multivariate binary regression analysis revealed that the risk of preoperative DVT in TJA patients with PLT≥202 × 109/L, MPV≤11.4 fL, PDW≤13.2 fL, P-LCR≤34.6%, and PCT≥0.228% increased by 2.32 (P &lt; .001, 95% confidence interval [CI] [1.50-3.60]), 1.86 (P &lt; .001, 95% CI [1.22-2.83]), 2.17 (P &lt; .001, 95% CI [1.43-3.31]), 2.27 (P &lt; .001, 95% CI [1.50-3.45]), and 1.76 times (P = .013, 95% CI [1.13-2.76]), respectively. Age, P &lt; .001, odds ratio (OR) = 1.08, 95% CI [1.04-1.11]; corticosteroid use, P = .011, OR = 3.66, 95% CI [1.34-9.96]. We found that increased PLT count and PCT, decreased MPV, PDW, and P-LCR, old age, and corticosteroid use were independent risk factors for preoperative DVT in elderly TJA patients.</description><identifier>ISSN: 1076-0296</identifier><identifier>ISSN: 1938-2723</identifier><identifier>EISSN: 1938-2723</identifier><identifier>DOI: 10.1177/10760296221149699</identifier><identifier>PMID: 36604786</identifier><language>eng</language><publisher>Los Angeles, CA: SAGE Publications</publisher><subject>Adrenal Cortex Hormones ; Aged ; Arthroplasty ; Blood Platelets ; Health risks ; Humans ; Joint surgery ; Mean Platelet Volume ; Older people ; Original Manuscript ; Perioperative care ; Platelet Count ; Regression analysis ; Retrospective Studies ; Steroids ; Thrombosis ; Venous Thrombosis - etiology</subject><ispartof>Clinical and applied thrombosis/hemostasis, 2023-01, Vol.29, p.10760296221149699</ispartof><rights>The Author(s) 2023</rights><rights>The Author(s) 2023. This work is licensed under the Creative Commons Attribution – Non-Commercial License https://creativecommons.org/licenses/by-nc/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>The Author(s) 2023 2023 SAGE Publications Inc. unless otherwise noted. 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A total of 1391 patients were enrolled. We created receiver operator characteristic (ROC) curve using the ratio of PLT indices to DVT before TJA, divided the enrolled patients into groups based on the cut-off value, and then analyzed risk factors for DVT before TJA in the multivariate binary logistic regression analysis. Preoperative DVT occurred in 103 cases. Based on the ROC curve, we determined that the cut-off values for PLT, mean platelet volume (MPV), platelet distribution width (PDW), platelet large cell ratio (P-LCR), and plateletcrit (PCT) were 202 × 109/L, 11.4 fL, 13.2 fL, 34.6%, and 0.228%. And the areas under the curve were 0.606, 0.605, 0.617, 0.616, and 0.598. Multivariate binary regression analysis revealed that the risk of preoperative DVT in TJA patients with PLT≥202 × 109/L, MPV≤11.4 fL, PDW≤13.2 fL, P-LCR≤34.6%, and PCT≥0.228% increased by 2.32 (P &lt; .001, 95% confidence interval [CI] [1.50-3.60]), 1.86 (P &lt; .001, 95% CI [1.22-2.83]), 2.17 (P &lt; .001, 95% CI [1.43-3.31]), 2.27 (P &lt; .001, 95% CI [1.50-3.45]), and 1.76 times (P = .013, 95% CI [1.13-2.76]), respectively. Age, P &lt; .001, odds ratio (OR) = 1.08, 95% CI [1.04-1.11]; corticosteroid use, P = .011, OR = 3.66, 95% CI [1.34-9.96]. 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A total of 1391 patients were enrolled. We created receiver operator characteristic (ROC) curve using the ratio of PLT indices to DVT before TJA, divided the enrolled patients into groups based on the cut-off value, and then analyzed risk factors for DVT before TJA in the multivariate binary logistic regression analysis. Preoperative DVT occurred in 103 cases. Based on the ROC curve, we determined that the cut-off values for PLT, mean platelet volume (MPV), platelet distribution width (PDW), platelet large cell ratio (P-LCR), and plateletcrit (PCT) were 202 × 109/L, 11.4 fL, 13.2 fL, 34.6%, and 0.228%. And the areas under the curve were 0.606, 0.605, 0.617, 0.616, and 0.598. Multivariate binary regression analysis revealed that the risk of preoperative DVT in TJA patients with PLT≥202 × 109/L, MPV≤11.4 fL, PDW≤13.2 fL, P-LCR≤34.6%, and PCT≥0.228% increased by 2.32 (P &lt; .001, 95% confidence interval [CI] [1.50-3.60]), 1.86 (P &lt; .001, 95% CI [1.22-2.83]), 2.17 (P &lt; .001, 95% CI [1.43-3.31]), 2.27 (P &lt; .001, 95% CI [1.50-3.45]), and 1.76 times (P = .013, 95% CI [1.13-2.76]), respectively. Age, P &lt; .001, odds ratio (OR) = 1.08, 95% CI [1.04-1.11]; corticosteroid use, P = .011, OR = 3.66, 95% CI [1.34-9.96]. We found that increased PLT count and PCT, decreased MPV, PDW, and P-LCR, old age, and corticosteroid use were independent risk factors for preoperative DVT in elderly TJA patients.</abstract><cop>Los Angeles, CA</cop><pub>SAGE Publications</pub><pmid>36604786</pmid><doi>10.1177/10760296221149699</doi><orcidid>https://orcid.org/0000-0002-8154-0230</orcidid><orcidid>https://orcid.org/0000-0002-5693-0544</orcidid><orcidid>https://orcid.org/0000-0003-3941-9602</orcidid><orcidid>https://orcid.org/0000-0003-4726-7055</orcidid><oa>free_for_read</oa></addata></record>
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subjects Adrenal Cortex Hormones
Aged
Arthroplasty
Blood Platelets
Health risks
Humans
Joint surgery
Mean Platelet Volume
Older people
Original Manuscript
Perioperative care
Platelet Count
Regression analysis
Retrospective Studies
Steroids
Thrombosis
Venous Thrombosis - etiology
title Association Between Platelet Indices and Preoperative Deep Vein Thrombosis in Elderly Patients Undergoing Total Joint Arthroplasty: A Retrospective Study
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