Application of Novel Thrombosis Scale in Fracture Related Lower Extremity Deep Venous Thrombosis

BackgroundLower limb fractures with peripheral deep venous thrombosis (DVT) are common, yet unified stratified treatment standards are lacking. Quantifying thrombus burden guides decisions like inferior vena cava (IVC) filter implantation or anticoagulation. Existing scoring systems rarely integrate peripheral vein anatomy and imaging features, limiting clinical utility.ObjectiveTo develop a dual-dimensional scoring scale for thrombus burden quantification and validate its value in guiding stratified treatment.MethodsA retrospective study of 68 fracture-related DVT patients (Suzhou TCM Hospital, Nov 2022-Nov 2023) was conducted. A 0-25 point scale integrating 7 peripheral veins and muscular venous plexus features was designed. Receiver operating characteristic (ROC) analysis identified the optimal IVC filter cutoff; patients were split into filter group (≥4 points, n = 21, filter + anticoagulation) and anticoagulation group (<4 points, n = 47, single anticoagulation). 1:2 PSM eliminated baseline confounding; adverse events, scores and coagulation indices were compared.ResultsNo adverse events or filter-related complications occurred. Both groups had significant post-treatment score and D-dimer reductions (all P < .05). ROC confirmed 4 points as optimal cutoff (AUC = 0.923). The filter group had lower hemoglobin and higher D-dimer (P < .05), with no PT/APTT differences. All filter group patients had residual thrombi, cord-like residuals in those with pre-treatment scores >5 points.ConclusionThis scale effectively quantifies thrombus burden, aids stratified DVT treatment, and provides a reliable basis for preoperative IVC filter implantation in orthopedic patients, with key clinical value.