Postoperative Coagulation State Predicts Deep Vein Thrombosis After Cesarean Section in Elderly Pregnant Women

Figures & data

Table 1 Univariate Analysis of Clinical Factors for Deep Vein Thrombosis (DVT) After Delivery in Elderly Pregnant Women Who Delivered by Cesarean Section

Clinical Factors	NDVT (n = 109)	DVT (n = 67)	p value
Age (years)	38.72 ± 2.24	39.88 ± 2.61	0.004
Antepartum BMI (kg/m^2)	27.43 ± 2.48	27.69 ± 2.71	0.216
Gestational weeks	38.58 ± 1.23	38.61 ±1.22	0.814
Parity, %
Primipara	52 (47.7%)	21 (31.3%)	0.041
Multipara	57 (52.3%)	46 (68.7%)
Multiple pregnancy, %
Yes	8 (7.3%)	7 (10.4%)	0.580
No	101 (92.7%)	60 (89.6%)
VTE history, %
Yes	3 (2.8%)	5 (7.5%)	0.262
No	106 (97.2%)	62 (92.5%)
Preeclampsia, %
Yes	15 (13.8%)	21 (31.3%)	0.007
No	94 (86.2%)	46 (68.7%)
Gestational diabetes mellitus, %
Yes	22 (20.2%)	24 (35.8%)	0.033
No	87 (79.8%)	43 (64.2%)
Hyperlipidemia, %
Yes	17 (15.6%)	16 (23.9%)	0.232
No	92 (84.4%)	51 (76.1%)
APTT (s)	29.01 ± 4.13	26.47 ± 5.52	0.002
PT (s)	12.43 ± 1.97	11.12 ± 2.12	< 0.001
Plasma D-dimer (mg/L)	0.38 ± 0.13	0.58 ± 0.28	< 0.001
Plasma FIB (g/L)	3.15 ± 0.61	3.91 ± 0.96	< 0.001
PLT (×10^9/L)	194.52 ± 52.97	254.48 ± 63.82	< 0.001

Notes: The data presented are mean ± SD or n (percentage). The comparisons of data between the two group were done by Mann–Whitney test or Unpaired t-test with Welch’s correction or Fisher’s exact test.

Abbreviations: BMI, body mass index; VTE, venous thromboembolism; APTT, activated partial thromboplastin time; PT, prothrombin time; FIB, fibrinogen; PLT, blood platelet count.

Table 2 Multivariate Logistic Analysis for Deep Vein Thrombosis (DVT) After Delivery in Elderly Pregnant Women Who Delivered by Cesarean Section

	OR	95% CI	p value
Age more than 39 years old	1.73	1.21 to 3.02	0.012
Multipara	1.25	0.89 to 2.96	0.191
Preeclampsia	1.36	1.08 to 1.71	0.023
Gestational diabetes mellitus	1.19	0.92 to 1.48	0.105
APTT less than 29.15 s	1.45	0.97 to 2.14	0.073
PT less than 11.45 s	1.52	0.94 to 2.83	0.087
Plasma D-dimer more than 0.56 mg/L	2.04	1.35 to 3.79	0.005
Plasma FIB more than 3.59 g/L	2.45	1.29 to 4.86	0.009
PLT more than 218.82 × 10^9/L	3.13	1.74 to 5.81	0.001

Abbreviations: OR, odds ratio; CI, confidence interval; APTT, activated partial thromboplastin time; PT, prothrombin time; FIB, fibrinogen; PLT, blood platelet count.

Figure 1 Comparisons of activated partial thromboplastin time (APTT, a), prothrombin time (PT, b), plasma D-dimer (c), plasma fibrinogen (FIB, d) and blood platelet count (PLT, e) within 24 hours after surgery between deep vein thrombosis (DVT) patients (n = 67) and without DVT occurrence (n = 109) after delivery in elderly pregnant women who delivered by cesarean section. Data were shown with mean ± SD. p values were calculated from Unpaired t-test with Welch’s correction.

Table 3 Predictive Values in ROC Analysis

	AUC (95% CI)	Cut Off	p value	Sensitivity (%)	Specificity (%)	Youden Index
APTT	0.64 (0.55 to 0.72)	29.15	0.003	74.63	53.21	0.28
PT	0.68 (0.59 to 0.76)	11.45	< 0.001	59.70	67.89	0.28
Plasma D-dimer	0.72 (0.64 to 0.80)	0.56	< 0.001	46.27	95.41	0.42
Plasma FIB	0.75 (0.67 to 0.82)	3.59	< 0.001	64.18	77.98	0.42
PLT	0.76 (0.69 to 0.84)	218.82	< 0.001	74.63	69.72	0.44
Model	0.94 (0.90 to 0.97)	-	< 0.001	86.57	85.32	0.72

Note: COMPUTE .

Abbreviations: AUC, area under the curve; CI, confidence interval; APTT, activated partial thromboplastin time; PT, prothrombin time; FIB, fibrinogen; PLT, blood platelet count.

Figure 2 ROC analysis of activated partial thromboplastin time (APTT), prothrombin time (PT), plasma D-dimer, plasma fibrinogen (FIB), blood platelet count (PLT) within 24 hours after surgery and their combined test model for the prediction of deep vein thrombosis (DVT) after delivery in elderly pregnant women who delivered by cesarean section.