Yang Du-Jiang, Li Mao, Yue Chao, Hu Wei-Ming, Lu Hui-Min
Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China.
Department of Pancreatic Surgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China.
World J Gastrointest Surg. 2021 Oct 27;13(10):1258-1266. doi: 10.4240/wjgs.v13.i10.1258.
Deep vein thrombosis (DVT) may cause pulmonary embolus, leading to late deaths. The systemic inflammatory and hypercoagulable state of moderate and severe acute pancreatitis (non-mild acute pancreatitis, NMAP) patients may contribute to the development of venous thromboembolism. Accurate prediction of DVT is conducive to clinical decisions.
To develop and validate a potential new prediction nomogram model for the occurrence of DVT in NMAP.
NMAP patient admission between 2013.1.1 and 2018.12.31 at the West China Hospital of Sichuan University was collected. A total of 220 patients formed the training set for nomogram development, and a validation set was constructed using bootstrapping with 100 resamplings. Univariate and multivariate logistic regression analyses were used to estimate independent risk factors associated with DVT. The independent risk factors were included in the nomogram. The accuracy and utility of the nomogram were evaluated by calibration curve and decision curve analysis, respectively.
A total of 220 NMAP patients over 60 years old were enrolled for this analysis. DVT was detected in 80 (36.4%) patients. The final nomogram included age, sex, surgery times, D-dimer, neutrophils, any organ failure, blood culture, and classification. This model achieved good concordance indexes of 0.827 (95%CI: 0.769-0.885) and 0.803 (95%CI: 0.743-0.860) in the training and validation sets, respectively.
We developed and validated a prediction nomogram model for DVT in older patients with NMAP. This may help guide doctors in making sound decisions regarding the administration of DVT prophylaxis.
深静脉血栓形成（DVT）可能导致肺栓塞，进而导致晚期死亡。中重度急性胰腺炎（非轻度急性胰腺炎，NMAP）患者的全身炎症和高凝状态可能促进静脉血栓栓塞的发生。准确预测DVT有助于临床决策。
开发并验证一种用于预测NMAP患者发生DVT的潜在新预测列线图模型。
收集2013年1月1日至2018年12月31日在四川大学华西医院住院的NMAP患者。共220例患者组成列线图开发的训练集，并通过100次重采样的自举法构建验证集。采用单因素和多因素逻辑回归分析来估计与DVT相关的独立危险因素。将独立危险因素纳入列线图。分别通过校准曲线和决策曲线分析评估列线图的准确性和实用性。
共纳入220例60岁以上的NMAP患者进行本分析。80例（36.4%）患者检测到DVT。最终的列线图包括年龄、性别、手术次数、D-二聚体、中性粒细胞、任何器官功能衰竭、血培养和分类。该模型在训练集和验证集中分别获得了良好的一致性指数，分别为0.827（95%CI：0.769-0.885）和0.803（95%CI：0.743-0.860）。
我们开发并验证了一种用于老年NMAP患者DVT的预测列线图模型。这可能有助于指导医生在DVT预防管理方面做出合理决策。
