Department of Urology, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, China.
Department of Statistics, School of Mathematics and Statistics, Beijing Technology and Business University, Haidian, Beijing, 100048, China.
Int J Surg. 2021 May;89:105948. doi: 10.1016/j.ijsu.2021.105948. Epub 2021 Apr 20.
Deep vein thrombosis (DVT) is among the most frequent complications of surgery. This study aimed to analyse the incidence and risk factors of lower extremity venous thrombosis after urologic surgery.
This prospective two-centre study was conducted from August 2019 to January 2020. Patients who underwent urological procedures were enrolled. The primary endpoint was the detection of asymptomatic or symptomatic DVT of the lower extremity within 7 days after surgery. Univariate and least absolute shrinkage and selection operator (LASSO) logistic regression analyses were performed.
Fifty-six of 1011 patients developed DVT. In the univariate analysis, Barthel Index ≤40, d-dimer level ≥0.5 mg/L and age ≥60 years (p < 0.001) were identified as the most significant risk factors. The LASSO logistic regression model identified nine factors: age, history of DVT, lymph node dissection, perioperative steroid use, Caprini score, Barthel Index, D-dimer level, cystectomy, and prostatectomy.
Our study used the LASSO logistic regression model to provide reliable data on the risk factors for DVT after comprehensive urologic surgery. The incidence of DVT in this group was 5.54%. This might facilitate individualised anticoagulant management in patients undergoing urological procedures.
深静脉血栓(DVT)是手术中最常见的并发症之一。本研究旨在分析泌尿外科手术后下肢静脉血栓形成的发生率和危险因素。
这是一项前瞻性的两中心研究,于 2019 年 8 月至 2020 年 1 月进行。纳入接受泌尿外科手术的患者。主要终点是术后 7 天内检测到无症状或有症状的下肢 DVT。进行单因素和最小绝对值收缩和选择算子(LASSO)逻辑回归分析。
1011 例患者中有 56 例发生 DVT。在单因素分析中,Barthel 指数≤40、D-二聚体水平≥0.5mg/L 和年龄≥60 岁(p<0.001)被确定为最显著的危险因素。LASSO 逻辑回归模型确定了 9 个因素:年龄、DVT 史、淋巴结清扫术、围手术期类固醇使用、Caprini 评分、Barthel 指数、D-二聚体水平、膀胱切除术和前列腺切除术。
本研究使用 LASSO 逻辑回归模型提供了全面泌尿外科手术后 DVT 危险因素的可靠数据。该组患者的 DVT 发生率为 5.54%。这可能有助于对接受泌尿外科手术的患者进行个体化抗凝管理。