Objective To investigate the correlations of the expression levels of serum microRNA-374b-5p (miR-374b-5p), P-selectin and tumor necrosis factor receptor-associated factor 6 (TRAF6) with deep vein thrombosis (DVT) in patients with traumatic lower limb fractures, and to construct a multi-indicator Logistic regression model to establish a postoperative DVT risk prediction tool.

Methods A total of 160 patients with traumatic lower limb fractures were selected as the study subjects and divided into DVT group (n=55) and non-DVT group (n=105) based on postoperative color Doppler ultrasound examination results. Clinical data of the patients were collected, and their coagulation and blood lipid indicators were tested. Real-time fluorescent quantitative polymerase chain reaction was used to detect the serum miR-374b-5p expression level within 24 hours postoperatively. Enzyme-linked immunosorbent assay (ELISA) was employed to measure serum P-selectin and TRAF6 levels, and their relationships with short-term postoperative DVT were analyzed. Logistic regression analysis was conducted to identify the influencing factors of postoperative DVT in patients with traumatic lower limb fractures, and a relevant model was established to assess the patients′ DVT risk.

Results There were no statistically significant differences in demographic characteristics (gender, age and body mass index), underlying diseases (hypertension, diabetes and varicose veins), treatment-related factors (postoperative hemostatic drug use and fracture site), and lifestyle habits (smoking history and alcohol consumption history) between the two groups (P>0.05). The proportion of patients in the DVT group with a postoperative first ambulation time of less than 7 days was significantly lower than that in the non-DVT group, while the levels of D-dimer and fibrinogen degradation products were significantly higher in the DVT group than those in the non-DVT group (P < 0.05). The high-density lipoprotein cholesterol level in the DVT group was significantly lower than that in the non-DVT group (P < 0.05). The relative expression levels of serum miR-374b-5p and the levels of P-selectin and TRAF6 in the DVT group were significantly higher than those in the non-DVT group (P < 0.05). Logistic regression analysis revealed that a postoperative ambulation time of ≥7 days, D-dimer, fibrinogen degradation products, high-density lipoprotein cholesterol, relative expression level of miR-374b-5p as well as levels of P-selectin and TRAF6 were influencing factors for postoperative DVT in patients. Based on these findings, a postoperative DVT prediction model was established, which showed an area under the curve (AUC) of 0.977 (95%CI: 0.953 to 0.992) for predicting postoperative DVT in patients.

Conclusion The serum levels of miR-374b-5p, P-selectin and TRAF6 are closely related to postoperative DVT in patients with traumatic lower limb fractures, and the prediction model established based on these factors has high predictive value.