Research progress on molecular markers for diagnosing VTE in orthopedic surgery patients

Venous thromboembolism (VTE) is a condition characterized by abnormal blood coagulation within the veins, leading to partial or complete obstruction of blood vessels and impaired blood flow. VTE is a severe complication of orthopedic surgery and a significant cause of postoperative and in-hospital mortality. This study reviews a series of molecular markers currently utilized in the diagnosis and analysis of VTE-related disorders. Among these, D-dimer (DD) is a unique marker of thrombosis and subsequent thrombolytic activity and is widely employed as a blood-based biomarker for the detection and exclusion of VTE, including deep vein thrombosis (DVT) and pulmonary embolism (PE). Additional thrombotic markers, such as thrombin-antithrombin complex (TAT), plasmin-α2-plasmin inhibitor complex (PIC), tissue plasminogen activator inhibitor complex (t-PAIC), and thrombomodulin (TM), are produced at the initial stages of thrombotic response and allow for a more sensitive and comprehensive evaluation of thrombosis development, thrombolytic efficacy, post-procedural thrombosis and hemorrhage, and vascular endothelial damage. Markers like FIB, RBC/Hb/HCT, soluble fibrin monomer complex (SFMC), and FXI are critical in the body's coagulation processes. Inflammatory factors are strongly linked to the pathogenesis of VTE, as inflammation can interfere with various stages of hemostasis, either by activating coagulation pathways or inhibiting fibrinolytic and anticoagulant mechanisms. Common inflammatory markers include C-reactive protein (CRP), neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), systemic immune-inflammation index (SII), mean platelet volume (MPV), and platelet-to-hemoglobin ratio (PHR). Furthermore, emerging indicators such as serum albumin, glucose levels, and platelet/sodium ratio (P/Na) are also being explored. In conclusion, a variety of coagulation, inflammation, and novel markers have significant potential for the diagnosis, prognosis, and treatment of VTE, enhancing clinical outcomes and improving management strategies for affected patients.