Association between inflammation‑based index and acute deep vein thrombosis and thrombus burden

Inflammation is pivotal in venous thrombogenesis. Complete blood count (CBC)-derived inflammation indexes are emerging biomarkers, but their value for diagnosing acute deep vein thrombosis (DVT) and stratifying thrombus burden requires further investigation.

To evaluate CBC-derived inflammation indexes-neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), lymphocyte-to-monocyte ratio (LMR), and systemic inflammation response index (SIRI)-for diagnosing acute DVT and stratifying thrombus burden.

In this retrospective study, 360 patients referred for venous Doppler ultrasound were categorized into non-DVT (n = 200), isolated distal DVT (IDDVT, n = 114), and proximal DVT (PDVT, n = 46) groups. Demographic data, comorbidities, and CBC parameters were collected to calculate the indexes. Predictive ability was assessed using receiver operating characteristic (ROC) curve analysis, and group differences were evaluated with the Kruskal-Wallis and Dunn's tests.

Acute DVT patients showed significantly elevated NLR, PLR, SII, and SIRI, and reduced LMR. ROC analysis indicated LMR had the highest predictive efficacy for acute DVT (AUC: 0.737) with high specificity (85.5%). For distinguishing IDDVT from PDVT, only NLR and LMR showed significant discriminative value.

NLR and LMR are valuable biomarkers for diagnosing acute DVT and assessing thrombus burden. Their high specificity supports adjunctive use in risk stratification, but their low sensitivity necessitates integration with comprehensive clinical assessment.