Deep Vein Thrombosis Risk Prediction after Total Hip Replacement at Kandou Hospital

2026-10-02T06:07:37+00:00

Deep vein thrombosis (DVT) is a clinically significant complication following total hip arthroplasty (THA), requiring a clear distinction between observed postoperative events and model-based risk estimates. This prospective cohort study enrolled 62 patients who underwent THA at Prof. Dr. R. D. Kandou Hospital in Manado, Indonesia, between January 2023 and December 2024, with a 90-day follow-up period. Clinical characteristics, Wells scores, D-dimer levels, fibrinogen levels, and Doppler ultrasonography findings were recorded. Descriptive findings indicated that 46 participants (74%) were male, 48 (77%) had elevated D-dimer levels, and all documented Doppler ultrasonography examinations yielded normal findings. A Monte Carlo simulation comprising 10,000 iterations was also performed using a logistic regression equation with coefficients reportedly derived from published literature rather than estimated from the study cohort. The simulation yielded a median predicted DVT prevalence of 7.3%, with a 95% prediction interval of 0%–29%. However, this estimate represented a simulation-derived outcome rather than the observed incidence of postoperative DVT. The available manuscript did not report the actual number of incident DVT events during the 90-day follow-up and contained an unresolved inconsistency between the exclusion of patients with active cancer and the reported inclusion of seven participants with active cancer. [AUTHOR DATA REQUIRED: Confirm the number of observed DVT events during follow-up and clarify the eligibility criteria concerning active cancer.] Overall, the study provided descriptive information on clinical characteristics and potential DVT risk factors in a local THA population, alongside an exploratory simulation-based risk estimation framework. Nevertheless, cohort-specific predictive associations, model discrimination, and calibration could not be established without verification of the observed clinical outcomes, model coefficients, and estimation procedures.

Association Between Nocturnal Blood Pressure Dipping and Renal Injury: A Systematic Literature Review

2026-10-02T06:04:24+00:00

This systematic literature review synthesized quantitative evidence on the association between nocturnal blood pressure (BP) dipping patterns and renal injury, disease progression, and severity. PubMed was searched using structured search terms related to nocturnal BP, ambulatory blood pressure monitoring (ABPM), and renal outcomes. The search included original quantitative studies published in English between 2015 and 2026. Study eligibility was determined using the Population, Exposure, Comparator, and Outcome (PECO) framework, and the review was reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. Methodological quality was assessed using the QualSyst appraisal tool. [AUTHOR DATA REQUIRED: Specify the exact date of the final PubMed search and clarify the study selection and quality assessment procedures, including the number of reviewers involved.] A total of 596 records were identified, of which 35 primary studies were included in the review. However, discrepancies in the intermediate PRISMA screening counts required verification against the original screening records. Across the included studies, nondipping and, particularly, reverse-dipping (riser) patterns were generally associated with albuminuria, reduced estimated glomerular filtration rate (eGFR), structural kidney injury, chronic kidney disease (CKD) progression, kidney failure, initiation of dialysis, and composite kidney outcomes. Conversely, a greater physiological decline in nocturnal BP was generally associated with more favorable renal outcomes. Nevertheless, the magnitude and independence of these associations varied according to patient population, CKD stage, outcome definitions, dipping thresholds, absolute nighttime BP, 24-hour BP burden, BP variability, and statistical adjustment methods. Overall, the findings suggested that nocturnal BP dipping patterns provided complementary prognostic information for renal risk assessment rather than serving as independent or definitive determinants of renal outcomes. The interpretation of these findings was limited by substantial clinical and methodological heterogeneity, the predominance of observational study designs, the restriction to English-language publications, and the exclusive use of PubMed as the literature database.

Jurnal Health Sains

Deep Vein Thrombosis Risk Prediction after Total Hip Replacement at Kandou Hospital

Association Between Nocturnal Blood Pressure Dipping and Renal Injury: A Systematic Literature Review