Influencing Factors and Construction of a Predictive Model for Lower Extremity Deep Vein Thrombosis after Total Knee...

To identify risk factors for deep vein thrombosis (DVT) following total knee arthroplasty (TKA) and to develop a predictive nomogram model.

An observational study. Place and Duration of the Study: Department of Orthopaedics, Nanjing Pukou People's Hospital, Liangjiang Hospital, Southeast University, Nanjing, China, from March 2018 to March 2022.

Among the 1,015 eligible TKA patients, 457 developed postoperative DVT (DVT group), and 558 served as controls (non-DVT group). Risk factors were identified through univariate analysis and multivariate logistic regression.

The DVT group showed significantly higher proportions of patients aged age ≥65 years, BMI ≥28 kg/m2, female gender, history of diabetes, cemented prosthesis, operation duration ≥90 minutes, bed rest duration ≥72 hours, no mechanical thromboprophylaxis, D-dimer levels >0.545 mg/L, and von Willebrand factor (vWF) level >178.55 ng/mL (all p <0.05) vs. the non-DVT group. Independent risk factors for DVT included age ≥65 years, BMI ≥28 kg/m2, female gender, history of diabetes, cemented prosthesis, operation duration ≥90 minutes, bed rest duration ≥72 hours, no mechanical thromboprophylaxis, D-dimer >0.545 mg/L, and vWF >178.55 ng/mL. A predictive nomogram incorporated these variables using regression coefficients (e.g., age × 1.128 ... vWF × 6.225; intercept = 4.545).

Key modifiable and non-modifiable factors influence the risk of DVT following TKA. The predictive validated nomogram demonstrates clinical utility for individualised risk stratification and prevention strategies.

Total knee arthroplasty, Deep vein thrombosis, Risk factors, Predictive model.