Linli Lou, Mian Lin, Xuerong Huang, Xiaoxiao Yan
Admission NLR and DAR were independently associated with subsequently detected in-hospital DVT after sICH. The two-biomarker model showed moderate discrimination but did not significantly outperform DAR alone, warranting prospective external validation.
BACKGROUND: Deep Vein Thrombosis (DVT) is a frequent complication in patients with spontaneous intracerebral hemorrhage (sICH). Identifying readily available biomarkers associated with DVT risk may improve early risk stratification.
METHODS: This single-center retrospective study enrolled 447 patients with sICH admitted between August 2023 and January 2026. All patients had negative results on bilateral lower-extremity venous ultrasonography within 48 hours of admission. Repeat ultrasonography was scheduled every 5 to 7 days and before discharge, and additional examinations were arranged when patients developed lower-extremity symptoms or experienced marked D-dimer elevation. Both symptomatic and asymptomatic, distal and proximal DVT cases were included in the analysis. Multivariable logistic regression and ROC curve analyses were conducted to assess factors associated with DVT, including NLR and DAR.
RESULTS: Among them, 94 patients were diagnosed with incident DVT during hospitalization, corresponding to an incidence of 21.03%. Patients with DVT were significantly older and had higher Padua scores. Neutrophil count, fibrinogen, D-dimer, NLR, and DAR were significantly higher in the DVT group, whereas lymphocyte count, albumin level, and hemoglobin level were lower. In multivariable analysis, age (adjusted OR, 1.046; 95% CI, 1.021-1.071), Padua score (adjusted OR, 1.430; 95% CI, 1.122-1.823), NLR (adjusted OR, 1.064; 95% CI, 1.008-1.124), and DAR (per 0.01-unit increase: adjusted OR, 1.107; 95% CI, 1.026-1.196) were independently associated with DVT. The AUCs were 0.677 for NLR, 0.718 for DAR, and 0.740 for the combined model. The combined-model AUC was higher than that of NLR (P=0.007) but not significantly different from that of DAR (P=0.276). Calibration was imperfect, although bootstrap internal validation suggested limited optimism.
CONCLUSION: Admission NLR and DAR were independently associated with subsequently detected in-hospital DVT after sICH. The two-biomarker model showed moderate discrimination but did not significantly outperform DAR alone, warranting prospective external validation.