Association between serum albumin and preoperative Deep Vein Thrombosis in patients aged 80 and over with intertrochanteric fracture: A retrospective observational study

OBJECTIVE: The association between serum albumin level and preoperative deep vein thrombosis (DVT) in patients aged ≥ 80 years with intertrochanteric fractures remains unclear. This study aimed to examine the association between serum albumin level and preoperative DVT and to explore whether the relationship between serum albumin and DVT exhibits a nonlinear pattern. METHODS: This retrospective observational study included 1484 consecutive patients aged ≥ 80 years with intertrochanteric fractures who were admitted to our hospital between January 2016 and July 2024. Vital signs, laboratory data, and comorbidities were collected for all participants to examine the association between serum albumin and preoperative DVT. To assess the independent association between serum albumin and DVT, we employed multivariable logistic regression analyses and smooth curve fitting. Subgroup analyses and interaction tests were conducted, followed by sensitivity analyses using propensity score matching. RESULTS: A total of 1484 patients aged ≥ 80 years with intertrochanteric fractures were included in the study. After adjusting for potential confounders, each 1 g/L higher serum albumin level was associated with 5% lower odds of preoperative DVT (odds ratio [OR], 0.95; 95% confidence interval [CI], 0.92-0.97, P < 0.01). A linear relationship was observed between serum albumin and preoperative DVT, and participants in the highest quartile of serum albumin had significantly lower preoperative DVT than those in the lowest quartile. Similar patterns were observed in subgroup analyses, with significant interaction effects noted for coronary heart disease, and sensitivity analyses showed that the results were robust. CONCLUSIONS: Reduced serum albumin concentrations demonstrate a significant association with elevated preoperative DVT in patients aged ≥80 years with intertrochanteric fractures, and further studies are required to confirm this relationship.