Inflammatory Biomarkers in Venous Thromboembolism: Distinguishing Proximal and Distal DVT Subtypes and Assessing Pulmonary Embolism Risk

Authors : Murat Yücel, Muhammet Fethi Sağlam, Kemal Erdoğan, Op. Dr. Onur Karahasanoğlu, Serdar Günaydın

Pages : 662-670

Doi:10.18663/tjcl.1785597

View : 49 | Download : 212

Publication Date : 2026-01-01

Article Type : Research Paper

Abstract :Abstract Background: Deep vein thrombosis (DVT) is a major cause of morbidity and mortality. Proximal DVT carries a higher risk of pulmonary embolism (PE), but the distinct inflammatory profiles of proximal and distal DVT remain unclear. Objectives: This study aims to compare the distribution of next-generation systemic inflammatory indices (SII, SIRI, AISI, NLR, PLR, MLR) and conventional biomarkers (CRP, D-dimer) and to evaluate the diagnostic and prognostic value of these parameters in predicting PE. Additionally, the effects of demographic and etiological differences between groups on the systemic inflammatory response were analyzed; the findings were validated using logistic regression models and ROC curve metrics to identify independent predictive markers. Methods: In this retrospective case-control study, 750 patients (2019–2025) with suspected lower extremity DVT were classified into proximal DVT (n=250), distal DVT (n=250), and Doppler-negative control group (n=250). Inflammatory indices [SII, SIRI, AISI, NLR, PLR, MLR], conventional biomarkers (CRP, D-dimer), and biochemical parameters were evaluated. Group differences were tested using ANOVA/Kruskal–Wallis, while logistic regression and ROC analyses identified predictors of proximal DVT and PE. Results: Patients with proximal DVT had significantly higher inflammatory indices, CRP, and D-dimer values compared to those with distal DVT and controls (all p<0.001). Distal DVT showed no significant difference from controls except for high SIRI (p<0.001). Proximal DVT was also associated with higher creatinine and LDH (Lactate Dehydrogenase) and lower sodium levels (all p<0.001). In multivariate regression, NLR (aOR 1.24, p=0.042) and D-dimer (aOR 1.43, p<0.001) independently predicted proximal DVT. For PE, D-dimer showed the highest accuracy (AUC 0.827, sensitivity 95.6%, specificity 61.8%), while NLR provided moderate discriminatory power (AUC 0.669).
Keywords : deriven trombozu, pulmoner emboli, inflamatuar indeksler, D-dimer, NLR

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