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Background <p>Deep vein thrombosis (DVT) is a leading cause of morbidity and mortality in frail older adults, particularly those receiving home healthcare. Conventional diagnostic tools such as D-dimer often lack specificity in this population, creating a clinical need for accessible, reliable biomarkers.</p> Aim <p>This study aimed to evaluate the predictive value of routinely available inflammatory and nutritional indices for DVT in frail elderly individuals.</p> Methods <p>In this prospective cohort study (December 2023–May 2025), frail adults aged ≥65 years receiving home healthcare were systematically evaluated for suspected DVT using Doppler ultrasonography. Demographic, clinical, and laboratory variables—including serum albumin, C-reactive protein (CRP), CRP-to-albumin ratio (CAR), albumin-to-globulin ratio (AGR), and systemic immune-inflammation index (SII)—were assessed. Logistic regression analyses identified independent predictors, while receiver operating characteristic (ROC) curves quantified diagnostic performance.</p> Results <p>Among 161 participants, 48 were diagnosed with DVT and 113 served as controls. AGR emerged as the most robust independent predictor (OR = 0.022, 95% CI: 0.004–0.140, p &lt; 0.001). An AGR cut-off of 1.125 yielded 75.0% sensitivity, 73.5% specificity, and an AUC of 0.742. CRP (AUC=0.651) and CAR (AUC=0.654) demonstrated moderate diagnostic accuracy, whereas albumin alone was borderline significant. DVT patients more often had Parkinson’s disease, while anticoagulant use was higher among controls.</p> Conclusion <p>In frail older adults, AGR emerged as the most robust biomarker for predicting DVT. Easily derived from routine laboratory tests, AGR may complement clinical evaluation and support early recognition in this vulnerable population. Larger multicenter studies are warranted to confirm these findings.</p>

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Association between the albumin-to-globulin ratio and deep vein thrombosis in older adults receiving home healthcare: a prospective cohort study

  • 期刊论文

  • 发表日期：

    2026年6月1日

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  • Nur Simsek Yurt,
  • Erdinc Yavuz,
  • Mehmet Maruf Aydin

摘要

Background

Deep vein thrombosis (DVT) is a leading cause of morbidity and mortality in frail older adults, particularly those receiving home healthcare. Conventional diagnostic tools such as D-dimer often lack specificity in this population, creating a clinical need for accessible, reliable biomarkers.

Aim

This study aimed to evaluate the predictive value of routinely available inflammatory and nutritional indices for DVT in frail elderly individuals.

Methods

In this prospective cohort study (December 2023–May 2025), frail adults aged ≥65 years receiving home healthcare were systematically evaluated for suspected DVT using Doppler ultrasonography. Demographic, clinical, and laboratory variables—including serum albumin, C-reactive protein (CRP), CRP-to-albumin ratio (CAR), albumin-to-globulin ratio (AGR), and systemic immune-inflammation index (SII)—were assessed. Logistic regression analyses identified independent predictors, while receiver operating characteristic (ROC) curves quantified diagnostic performance.

Results

Among 161 participants, 48 were diagnosed with DVT and 113 served as controls. AGR emerged as the most robust independent predictor (OR = 0.022, 95% CI: 0.004–0.140, p < 0.001). An AGR cut-off of 1.125 yielded 75.0% sensitivity, 73.5% specificity, and an AUC of 0.742. CRP (AUC=0.651) and CAR (AUC=0.654) demonstrated moderate diagnostic accuracy, whereas albumin alone was borderline significant. DVT patients more often had Parkinson’s disease, while anticoagulant use was higher among controls.

Conclusion

In frail older adults, AGR emerged as the most robust biomarker for predicting DVT. Easily derived from routine laboratory tests, AGR may complement clinical evaluation and support early recognition in this vulnerable population. Larger multicenter studies are warranted to confirm these findings.