Deep venous thrombosis (DVT) prediction after total hip and knee arthroplasty remains challenging. Early diagnosis and treatment of DVT are crucial. This research aimed to develop a nomogram for early DVT prediction. A total of 317 patients undergoing primary total hip and knee arthroplasty in Sun Yat-sen Memorial Hospital were enrolled between May 2020 and September 2022. Data from May 2020 to February 2022 were used as the development datasets to build the nomogram model (n = 238). Using multivariate logistic regression, independent variables and a nomogram for predicting the occurrence of DVT were identified. Datasets used to validate the model for internal validation ranged from March 2022 to September 2022 (n = 79). The nomogram’s capacity for prediction was also compared with the Caprini score. For both the development and validation datasets, DVT was found in a total of 38 (15.97%) and 9 patients (11.39%) on post-operative day 7 (pod7), respectively. 59.6% patients were symptomatic DVT (leg swelling). The multivariate analysis revealed that surgical site (Knee vs. Hip), leg swelling and thrombin-antithrombin complex (TAT) were associated with DVT. The previously indicated variables were used to build the nomogram, and for the development and validation datasets, respectively. In development and validation datasets, the area under the receiver operating characteristic curve was 0.836 and 0.957, respectively. In both datasets, the predictive value of the Nomogram is greater than the Caprini score. A proposed nomogram incorporating surgical site (Knee vs. Hip), leg swelling, and thrombin antithrombin complex (TAT) may facilitate the identification of patients who are more prone to develop DVT on pod7.

中文翻译：

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初次全髋关节和膝关节置换术患者深静脉血栓形成风险的预测列线图：一项回顾性研究

全髋关节和膝关节置换术后深静脉血栓（DVT）的预测仍然具有挑战性。DVT 的早期诊断和治疗至关重要。本研究旨在开发用于早期 DVT 预测的列线图。2020年5月至2022年9月期间，共纳入317例在中山纪念医院接受初次全髋关节置换术的患者。以2020年5月至2022年2月的数据作为开发数据集，构建列线图模型（n = 238） ）。使用多元逻辑回归、自变量和列线图来预测 DVT 的发生。用于验证内部验证模型的数据集范围为 2022 年 3 月至 2022 年 9 月 (n = 79)。列线图的预测能力也与 Caprini 分数进行了比较。对于开发和验证数据集，术后第 7 天 (pod7) 分别有 38 名患者 (15.97%) 和 9 名患者 (11.39%) 发现 DVT。59.6% 的患者有症状 DVT（腿部肿胀）。多变量分析显示，手术部位（膝关节与髋关节）、腿部肿胀和凝血酶-抗凝血酶复合物 (TAT) 与 DVT 相关。前面指出的变量用于构建列线图，并分别用于开发和验证数据集。在开发和验证数据集中，受试者工作特征曲线下面积分别为 0.836 和 0.957。在两个数据集中，列线图的预测值均大于 Caprini 分数。拟议的包含手术部位（膝盖与臀部）、腿部肿胀和凝血酶抗凝血酶复合物（TAT）的列线图可能有助于识别在 pod7 上更容易发生 DVT 的患者。