Elevated D-Dimer and Low Albumin Linked to Higher DVT Risk in Subtrochanteric Fractures: Study

"Deep vein thrombosis was detected in 42.5% of patients with subtrochanteric fractures, with elevated D-dimer levels (>750 ng/ml) and low serum albumin (<36.6 g/L) emerging as significant risk factors. D-dimer demonstrated high specificity (82.35%), while serum albumin exhibited greater sensitivity (73.5%). These biomarkers could aid in the early identification of high-risk patients, enabling the implementation of targeted preventive measures against DVT," the researchers reported.

The researchers note that subtrochanteric fractures, accounting for 5–10% of proximal femoral fractures, pose significant challenges due to a high risk of nonunion and fixation failure. Patients with orthopedic trauma, particularly these fractures, face an increased incidence of deep vein thrombosis (DVT), leading to prolonged hospitalization and rising healthcare costs. With limited research on its prevalence and risk factors, effective identification and prediction methods remain lacking.

To fill this knowledge gap, Yinguang Zhang, Department of Orthopaedic Surgery, Tianjin Hospital, Tianjin, China, and colleagues aimed to assess the occurrence and key contributors to lower limb DVT in patients with subtrochanteric fractures.

For this purpose, the researchers conducted a retrospective analysis of patients with subtrochanteric fractures admitted between 2019 and 2022. All patients underwent Doppler ultrasound to detect lower extremity DVT. Demographic data, comorbidities, and serum markers, including RBC, hemoglobin, lymphocytes, and triglycerides, were analyzed. Significant variables were further assessed using multiple regression models to identify independent risk factors associated with DVT.

The following were the key findings of the study:

• The study included 120 patients, comprising 80 males and 40 females, with an average age of 58.3 years.
• Deep vein thrombosis was diagnosed in 51 patients, with an incidence rate of 42.5%.
• Significant differences were observed between patients with and without DVT in albumin, total protein, RBC, hemoglobin, and D-dimer levels.
• Multivariate analysis identified elevated D-dimer levels (>750 ng/ml) and reduced serum albumin as independent risk factors for DVT.
• The optimal D-dimer cut-off for diagnosing DVT in subtrochanteric fractures was 750 ng/ml, with 56.52% sensitivity and 82.35% specificity.
• The ideal albumin cut-off was 36.6 g/L, showing 73.2% sensitivity and 41.2% specificity.
• The area under the curve (AUC) of 0.63 indicated moderate effectiveness in distinguishing conditions related to albumin levels.

The researchers concluded that elevated D-dimer levels and reduced serum albumin are independent predictors of DVT in patients with subtrochanteric fractures. These findings offer valuable insights for assessing DVT risk and tailoring individualized intervention programs.

Reference:

Zhou, Y., Jiang, M., Wang, S. et al. Admission deep venous thromboembolism of the lower extremity in patients of subtrochanteric fractures: a retrospective study. BMC Musculoskelet Disord 26, 176 (2025). https://doi.org/10.1186/s12891-025-08391-8