关键词: 股骨粗隆间骨折, 术后深静脉血栓, 术前Caprini模型评分, 中性粒细胞/淋巴细胞比值

Abstract: Objective To investigate the predictive value of Caprini model score combined with neutrophil/lymphocyte ratio (NLR) for deep vein thrombosis in elderly patients with intertrochanteric fracture.Methods A total of 70 elderly patients with intertrochanteric femoral fractures who received surgical treatment in the hospital from November 2022 to May 2024 were prospectively selected as the study subjects.The enrolled patients were divided into occurrence group and non-occurrence group according to whether DVT was complicated during postoperative hospitalization.,general data,surgery-related indexes were compared between the two groups,multivariate Logistic regression analysis was used to identify the risk factors affecting postoperative DVT.The efficacy of Caprini model score combined with NLR in predicting postoperative DVT was evaluated by receiver operating characteristic curve (ROC).Results Compared with the non-occurrence group,the Caprini model score,NLR,combined diabetes rate,Ddimer (D -D) and hypersensitive Creactive protein (hs-CRP) levels in the occurrence group were higher (P<0.05),the injury-hospital admission time was longer (P<0.05),the intraoperative blood loss was greater (P<0.05),and the platelet-derived growth factor (PDGF) was lower (P<0.05).Logistic multivariate regression analysis results show that Caprini model has high score (OR=2.044,95%CI:1.825~2.764),high NLR (OR=2.008,95%CI:1.840~2.696),combined with diabetes (OR=1.834,95%CI:1.726~2.463),long duration of injury-hospital admission (OR=1.828,95%CI:1.625~2.531),large intraoperative blood loss (OR=1.851,95%CI:1.682~2.421),high D-D level (OR=1.910,95%CI:1.771~2.605) and low PDGF level (OR=1.934,95%CI:1.706~2.568) were risk factors for deep vein thrombosis in elderly patients with intertrochanteric fracture.ROC curve results show that the sensitivity and AUC of Caprini model score combined with NLR in predicting postoperative deep vein thrombosis in elderly patients with intertrochanteric fracture are 90.50% and 0.902,respectively,these indexes are higher than Caprini model score (87.20%,0.869) and NLR (84.60%,0.848).Conclusion Both Caprini model score and NLR are higher in elderly patients with DVT after operation,and Caprini model score combined with NLR is more effective in predicting DVT after operation.

Key words: intertrochanteric fracture of femur, postoperative deep vein thrombosis, preoperative Caprini model score, neutrophil/lymphocyte ratio