Establishment and validation of a predictive nomogram for preoperative deep vein thrombosis in elderly patients with isolated femoral neck fracture
Abstract Current assessment of preoperative deep vein thrombosis (DVT) in elderly patients with femoral neck fracture is limited. We aimed to identify independent risk factors for preoperative DVT in patients with femoral neck fracture and to develop and validate a predictive nomogram. Patients diag...
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Nature Portfolio
2025-07-01
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| Online Access: | https://doi.org/10.1038/s41598-025-06305-1 |
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| author | Tianyu Wang Hongyuan Yin Chengsi Li Changhui Li Dongwei Wu Zhenbang Yang Xuebin Zhang Yingze Zhang Yanbin Zhu |
| author_facet | Tianyu Wang Hongyuan Yin Chengsi Li Changhui Li Dongwei Wu Zhenbang Yang Xuebin Zhang Yingze Zhang Yanbin Zhu |
| author_sort | Tianyu Wang |
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| description | Abstract Current assessment of preoperative deep vein thrombosis (DVT) in elderly patients with femoral neck fracture is limited. We aimed to identify independent risk factors for preoperative DVT in patients with femoral neck fracture and to develop and validate a predictive nomogram. Patients diagnosed with femoral neck fracture from October 2014 to April 2019 were retrospectively analyzed. Baseline data, treatment information and laboratory test results were collected, and the occurrence of DVT in the preoperative period was regarded as the study outcome event. Multivariable logistic regression identified independent risk factors associated with a higher incidence of preoperative DVT. The predictive nomogram was constructed based on the analysis results. The stability of the model was further assessed in this study using patients from May 2019 to September 2022 as an external validation set. A total of 921 patients were enrolled in the study, of which 639 were used in the training cohort and the other 282 for the validation cohort. Multivariate analysis revealed age (OR 1.100, 95% CI 1.042–1.162), BMI ≥ 28 (OR 3.969, 95% CI 1.792–8.793), smoking (OR 2.998, 95% CI 1.255–7.165), LDL-C > 3.4 mmol/L (OR 2.628, 95% CI 1.316–5.250), and d-dimer > 0.475 mg/L (OR 3.157, 95% CI 1.565–6.368) were the independent risk factors of preoperative DVT. The concordance index (C-index) of the nomogram were 0.832 in the training set, and the corrected values after internal validation were 0.759. The receiver-operating characteristic (ROC) curve, the calibration curve, the Hosmer–Lemeshow test and the decision curve analysis (DCA) performed well in both the training and validation cohorts. In this study, we developed a personalised predictive nomogram containing five high-risk factors, which can help surgeons stratify the risk of preoperative DVT in elderly patients with femoral necks and guide high-risk patients to ultrasound scans or prophylactic anticoagulation as soon as possible. |
| format | Article |
| id | doaj-art-430bed34802e4a9b886b46ec5860efec |
| institution | Kabale University |
| issn | 2045-2322 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj-art-430bed34802e4a9b886b46ec5860efec2025-08-20T04:01:24ZengNature PortfolioScientific Reports2045-23222025-07-0115111010.1038/s41598-025-06305-1Establishment and validation of a predictive nomogram for preoperative deep vein thrombosis in elderly patients with isolated femoral neck fractureTianyu Wang0Hongyuan Yin1Chengsi Li2Changhui Li3Dongwei Wu4Zhenbang Yang5Xuebin Zhang6Yingze Zhang7Yanbin Zhu8Department of Orthopaedic Surgery, Hebei Medical University Third HospitalDepartment of Orthopaedic Surgery, Hebei Medical University Third HospitalDepartment of Orthopaedic Surgery, Hebei Medical University Third HospitalDepartment of Orthopaedic Surgery, Hebei Medical University Third HospitalDepartment of Orthopaedic Surgery, Hebei Medical University Third HospitalDepartment of Orthopaedic Surgery, Hebei Medical University Third HospitalDepartment of Orthopaedic Surgery, Hebei Medical University Third HospitalDepartment of Orthopaedic Surgery, Hebei Medical University Third HospitalDepartment of Orthopaedic Surgery, Hebei Medical University Third HospitalAbstract Current assessment of preoperative deep vein thrombosis (DVT) in elderly patients with femoral neck fracture is limited. We aimed to identify independent risk factors for preoperative DVT in patients with femoral neck fracture and to develop and validate a predictive nomogram. Patients diagnosed with femoral neck fracture from October 2014 to April 2019 were retrospectively analyzed. Baseline data, treatment information and laboratory test results were collected, and the occurrence of DVT in the preoperative period was regarded as the study outcome event. Multivariable logistic regression identified independent risk factors associated with a higher incidence of preoperative DVT. The predictive nomogram was constructed based on the analysis results. The stability of the model was further assessed in this study using patients from May 2019 to September 2022 as an external validation set. A total of 921 patients were enrolled in the study, of which 639 were used in the training cohort and the other 282 for the validation cohort. Multivariate analysis revealed age (OR 1.100, 95% CI 1.042–1.162), BMI ≥ 28 (OR 3.969, 95% CI 1.792–8.793), smoking (OR 2.998, 95% CI 1.255–7.165), LDL-C > 3.4 mmol/L (OR 2.628, 95% CI 1.316–5.250), and d-dimer > 0.475 mg/L (OR 3.157, 95% CI 1.565–6.368) were the independent risk factors of preoperative DVT. The concordance index (C-index) of the nomogram were 0.832 in the training set, and the corrected values after internal validation were 0.759. The receiver-operating characteristic (ROC) curve, the calibration curve, the Hosmer–Lemeshow test and the decision curve analysis (DCA) performed well in both the training and validation cohorts. In this study, we developed a personalised predictive nomogram containing five high-risk factors, which can help surgeons stratify the risk of preoperative DVT in elderly patients with femoral necks and guide high-risk patients to ultrasound scans or prophylactic anticoagulation as soon as possible.https://doi.org/10.1038/s41598-025-06305-1Femoral neck fracturePreoperative deep vein thrombosisRisk factorPrediction model |
| spellingShingle | Tianyu Wang Hongyuan Yin Chengsi Li Changhui Li Dongwei Wu Zhenbang Yang Xuebin Zhang Yingze Zhang Yanbin Zhu Establishment and validation of a predictive nomogram for preoperative deep vein thrombosis in elderly patients with isolated femoral neck fracture Scientific Reports Femoral neck fracture Preoperative deep vein thrombosis Risk factor Prediction model |
| title | Establishment and validation of a predictive nomogram for preoperative deep vein thrombosis in elderly patients with isolated femoral neck fracture |
| title_full | Establishment and validation of a predictive nomogram for preoperative deep vein thrombosis in elderly patients with isolated femoral neck fracture |
| title_fullStr | Establishment and validation of a predictive nomogram for preoperative deep vein thrombosis in elderly patients with isolated femoral neck fracture |
| title_full_unstemmed | Establishment and validation of a predictive nomogram for preoperative deep vein thrombosis in elderly patients with isolated femoral neck fracture |
| title_short | Establishment and validation of a predictive nomogram for preoperative deep vein thrombosis in elderly patients with isolated femoral neck fracture |
| title_sort | establishment and validation of a predictive nomogram for preoperative deep vein thrombosis in elderly patients with isolated femoral neck fracture |
| topic | Femoral neck fracture Preoperative deep vein thrombosis Risk factor Prediction model |
| url | https://doi.org/10.1038/s41598-025-06305-1 |
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