Abstract: Objective To discuss the predictive value of microRNA, thrombus markers, and lower extremity deep vein thrombosis scoring system (Wells score) for reflecting the risk of deep vein thrombosis (DVT) in elderly patients with hip fracture to provide diagnostic evidence for reducing the incidence of DVT. Methods A total of 105 elderly patients with hip fracture admitted to our hospital from October 2020 to October 2022 were selected, and divided into DVT group (34 cases) and non-DVT group (71 cases) according to whether DVT occurred one week after surgery. Clinical data between the two groups were compared and Wells score was evaluated before surgery. MicroRNA substances [microRNA-374b-5p (miR-374b-5p), microRNA-664b-3p (miR-664b-3p)], thrombus markers [thrombin-antithrombin complex (TAT), soluble thrombomodulin (sTM), plasmin alpha2-antifibrinolytic complex (PIC), tissue-type plasminogen activator inhibitor complex (t-PAIC)] were detected. The factors influencing the occurrence of DVT were analyzed. The predictive value and clinical utility of Wells score, miR-374b-5p, miR-664b-3p, sTM, PIc, TAT, t-PAIC for predicting the risk of DVT in elderly hip fracture patients by receiver operating characteristic (ROC) curve and decision curve analysis (DCA). Results The plasma FDP level and Wells score in the DVT group before surgery were highly likely to be higher than those in the non-DVT group (P<0.05). The relative expression level of miR-374b-5p in the DVT group was higher than that in the non-DVT group, while the relative expression level of miR-664b-3p was lower (P<0.05). The plasma levels of sTM, PIC, TAT, and t-PAIC in the DVT group were higher than those in the non-DVT group (P<0.05). FDP, Wells score, miR-374b-5p, miR-664b-3p, sTM, PIC, TAT, and t-PAIC were all factors affecting the occurrence of DVT in elderly patients with hip fractures (P<0.05). The AUC values of Wells score, miR-374b-5p, miR-664b-3p, sTM, PIC, TAT, and t-PAIC were 0.666, 0.734, 0.750, 0.730, 0.764, 0.761, and 0.800, respectively. The combined prediction of DVT risk had the highest AUC value of 0.921, with good clinical utility (P<0.05). Conclusion The combination of miR-374b-5p, miR-664b-3p, sTM, PIC, TAT, t-PAIC and Wells score had high predictive efficacy and good clinical utility in predicting the risk of DVT in elderly patients with hip fracture.

Key words: Hip fracture, Deep vein thrombosis, Wells score, MiR-374b-5p, MiR-664b-3p