文献类型：期刊文献

英文题名：Prior intra-articular sodium hyaluronate injection as a novel predictor of isolated distal deep vein thrombosis after knee surgery: development and validation of a 5-factor nomogram

作者：Xie, Xiaoguang[1,2];Lu, Jie[2];Huang, Houmei[1];Wang, Yuerong[2];Ma, Menghui[1,2];Lai, Mengyun[1];Liu, Jing[1];Zheng, Xiaojing[2,3,4]

第一作者：Xie, Xiaoguang

通信作者：Zheng, XJ[1]

机构：[1]Shenzhen Luohu Dist Hosp Tradit Chinese Med, Shenzhen, Peoples R China;[2]Gansu Univ Tradit Chinese Med, Lanzhou, Peoples R China;[3]Shenzhen Luohu Hosp Grp, Luohu Peoples Hosp, Shenzhen, Peoples R China;[4]Luohu Peoples Hosp, 47 Rd, Shenzhen 518001, Guangdong, Peoples R China

第一机构：Shenzhen Luohu Dist Hosp Tradit Chinese Med, Shenzhen, Peoples R China

通信机构：[1]corresponding author), Luohu Peoples Hosp, 47 Rd, Shenzhen 518001, Guangdong, Peoples R China.

年份：2026

卷号：10

期号：4

外文期刊名：RESEARCH AND PRACTICE IN THROMBOSIS AND HAEMOSTASIS

收录：;Scopus(收录号：2-s2.0-105039699589);WOS:【SCI-EXPANDED(收录号:WOS:001790446200001)】；

基金：This research was supported by the Shenzhen Luohu District Soft Science Project Fund (LX202501056) and the Sanming Project of Medicine in Shenzhen (SZZYSM202101005).

语种：英文

外文关键词：hyaluronic acid; knee joint/surgery; nomograms; risk factors; venous thrombosis

摘要：Background: Isolated distal deep vein thrombosis (IDDVT) is a frequent but under-recognized complication after knee surgery. Existing prediction tools rarely target distal thrombosis specifically and often omit key perioperative laboratory, inflammatory, and procedural variables. Objectives: The study's objective was to pinpoint independent determinants of postoperative IDDVT and to design a personalized predictive nomogram. Methods: This retrospective analysis enrolled 1068 individuals who received knee operations during the period from 2019 to 2024. Demographic characteristics, laboratory biomarkers, inflammatory indices, anesthesia duration, and a history of intraarticular sodium hyaluronate injection were collected. Least absolute shrinkage and selection operator regression identified the relevant predictors, which were then input into a multivariable logistic regression model to produce the final algorithm. Model performance was evaluated through area under the curve (AUC) analysis, bootstrap-based calibration assessment, decision curve analysis, and examination of clinical impact curve. Results: IDDVT occurred in 84 patients (7.9%). Five variables were independently associated with IDDVT: D-dimer, fasting plasma glucose, neutrophil-to-lymphocyte ratio, anesthesia duration, and prior intra-articular sodium hyaluronate injection. The nomogram demonstrated excellent discrimination (area under the curve, 0.889; 95% CI, 0.851-0.927) and good calibration (Brier score, 0.052; calibration slope, 1.000). Both decision curve analysis and clinical impact curve demonstrated that the model offered substantial net benefit across threshold probabilities ranging from 1% to 74%. Conclusion: We developed and validated a 5-factor nomogram for predicting post-knee surgery IDDVT. Prior sodium hyaluronate injection emerged as a significant predictor, likely as a marker of advanced joint pathology. Further prospective studies are needed to integrate this finding into perioperative risk management.