ORIGINAL RESEARCH article
Front. Med.
Sec. Geriatric Medicine
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1635218
Preoperative albumin can predict the risk of postoperative deep venous thrombosis in non-cardiac surgery
Provisionally accepted
- 1Wansheng Economic and Technological Development Zone People’s Hospital, Chongqing, China
- 2Chongqing University Cancer Hospital, Chongqing, China
- 3Zhuhai City People's Hospital, Zhuhai, China
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Background: Postoperative deep venous thrombosis (DVT) is a critical complication of non-cardiac surgery. Hypoalbuminemia reflects both nutritional depletion and inflammation, which may contribute to DVT pathogenesis. In this study, we evaluated preoperative albumin's assciation with DVT in patients undergoing elective non-cardiac surgery, and identified risk-stratifying thresholds. Methods: A retrospective cohort study was conducted involving 2,026 adult patients (exclude local anesthesia cases) undergoing elective non-cardiac surgeries between December 1, 2023, and December 30, 2024. All patients received standardized postoperative surveillance by bilateral lower limb Doppler ultrasound during hospitalization. The primary exposure was preoperative serum albumin level, the primary outcome was postoperative DVT. Multivariable logistic regression was used to analyze the independent risk factors for postoperative DVT, and assess the prediction of preoperative albumin level. Results: Multivariable logistic regression revealed five independent risk factors for postoperative DVT (preoperative albumin, age, gender, surgical duration, and Caprini score). A linear dose-response relationship was observed between preoperative albumin levels and postoperative DVT incidence from a linear logistic regression. Each 1g/L decrement in preoperative albumin level increased the risk of postoperative DVT by 8.8% (adjusted OR (aOR): 1.088, 95%CI: 1.028-1.152) when analyzed as a continuous variable. The optimal preoperative albumin cut-off value was 41.9g/L to predict the risk of postoperative DVT (aOR:2.169, 95%CI:1.144-4.115), and the AUC was 0.885. Conclusion: Preoperative albumin (the cutoff is 41.9g/L) may help stratify DVT risk in intermediate-risk non-cardiac surgical patients, though prospective validation is needed given study limitations.
Keywords: Serum Albumin, Deep venous thrombosis, prediction, non-cardiac surgery serum albumin, Non-cardiac surgery
Received: 28 May 2025; Accepted: 04 Aug 2025.
Copyright: © 2025 Zhang, Pang, Liu, Chen, Wang, Duan and Liu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Hongliang Liu, Zhuhai City People's Hospital, Zhuhai, China
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