EARLY fibrinogen measurement was associated with an increased risk of deep venous thrombosis in older adults admitted with hip fracture, according to a new retrospective cohort study.
Deep venous thrombosis (DVT) is a frequent and serious complication following hip fracture in older adults.
Researchers found that patients with higher fibrinogen concentrations within 24 hours of admission were significantly more likely to develop DVT than those with lower levels.
The study evaluated 234 patients aged 60 years and older who were admitted with hip fracture between January 2020 and June 2023.
Bilateral lower extremity Doppler ultrasound was performed within 24 hours of admission, while blood samples were collected before pharmacological thromboprophylaxis was initiated.
Among the study population, 50 patients developed DVT, corresponding to an incidence of 21.4%.
Patients in the thrombosis group had longer times from injury to admission and exhibited higher concentrations of fibrinogen and C-reactive protein, alongside lower albumin levels.
Mean fibrinogen concentrations were significantly higher among patients who developed DVT compared with those who did not (4.15±1.11 g/L versus 3.47±0.84 g/L)
Univariate analysis demonstrated a significant association between fibrinogen levels and DVT. Even after accounting for factors such as age and sex, fibrinogen remained independently associated with DVT.
When fibrinogen levels reached or exceeded 4.15 g/L, the association strengthened further. These patients had a significantly elevated likelihood of DVT after multivariable adjustment.
Further analysis showed that fibrinogen demonstrated moderate predictive performance.
A combined model incorporating fibrinogen, C-reactive protein, and time from injury to admission achieved the strongest discrimination. By contrast, D-dimer showed limited diagnostic utility in this early admission setting,
The researchers concluded that elevated fibrinogen measured shortly after admission was independently associated with early DVT in older adults with hip fracture and could support early clinical risk assessment, while the role of D-dimer in this timeframe should be interpreted cautiously.
Future prospective studies could help confirm whether early fibrinogen testing improves risk stratification and guides thromboprophylaxis decisions in this high-risk patient group.
Reference
Lu D et al. Fibrinogen in early admission is an independent risk factor for early deep venous thrombosis in elderly patients with hip fracture. Sci Rep. 2026;DOI:10.1038/s41598-026-59049-x
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