In-hospital deep vein thrombosis after tibial plateau fractures: incidence, laterality/anatomy, and risk factors in a multicenter retrospective cohort of 3366 patients

Under protocolized inpatient duplex surveillance, patients with tibial plateau fracture had a substantial in-hospital burden of predominantly distal and ipsilateral DVT. Increasing age was independently associated with DVT; however, age alone showed limited discriminatory ability (AUC 0.593), with a cohort-derived Youden threshold of 42 years (age ≥ 42 years). Multiple injuries, anemia, alcohol use, shorter activated partial thromboplastin time (APTT), and lower serum sodium were independently associated with DVT, while the discrimination of age alone was modest. These findings may help inform risk stratification and the consideration of systematic or risk-adapted surveillance and individualized perioperative management; prospective studies are needed to determine whether risk-tailored strategies improve clinically meaningful outcomes.