56660Sir-Run-Run-Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
Deqing People's Hospital, Deqing, China.
Clin Appl Thromb Hemost. 2022 Jan-Dec;28:10760296211073748. doi: 10.1177/10760296211073748.
A retrospective study was carried out to construct a postoperative venous thromboembolism (VTE) risk assessment model (RAM) applicable for Chinese colorectal cancer patients.
541 Patients who underwent colorectal cancer surgery from June 2019 to May 2020 at Sir-Run-Run-Shaw Hospital affiliated to Zhejiang University School of Medicine were enrolled in this study. Multi-factor analysis was used to determine the independent risk factors of VTE. A novel RAM of VTE which we called Sir-Run-Run-Shaw VTE RAM were constructed basing on the independent risk factors. Another study cohort consisted of 287 colorectal cancer patients underwent surgery from January 2021 to June 2021was used for model evaluation.
The incidence of VTE after colorectal cancer surgery was 12.0%(65/541). Among the 65 VTE Patients, DVT accounted for 92.3% (60/65) and DVT + PE accounted for 7.7% (5/65). Multi-factor analysis showed that age ≥ 69 years ( < 0.01), preoperative plasma D-dimer ≥ 0.49 mg/L ( = .004), stage IV of cancer ( = .018) and transfusion ( = .004) are independent risk factors of VTE after surgery. Sir-Run-Run-Shaw VTE RAM includes the above 4 factors, and the total score is 4 points. The score of the low, medium and high risk groups are 0, 1 and ≥2 points. The area under the ROC curve (AUC) of Sir-Run-Run-Shaw VTE RAM is 0.769, while Caprini RAM is 0.656. There is statistical difference between the two risk score tables ( = 2.337, = .0195).
A VTE RAM is constructed basing on a single center retrospective study. This score table may be applicable for Chinese patients with colorectal cancer surgery.
本研究通过回顾性分析，构建一个适用于中国结直肠癌患者的术后静脉血栓栓塞症（venous thromboembolism，VTE）风险评估模型（risk assessment model，RAM）。
回顾性分析 2019 年 6 月至 2020 年 5 月浙江大学医学院附属邵逸夫医院收治的 541 例行结直肠癌手术患者的临床资料，采用多因素分析确定 VTE 的独立危险因素，基于独立危险因素构建新的 VTE RAM（称为邵逸夫 VTE RAM）。另外一项研究队列纳入 2021 年 1 月至 2021 年 6 月在本院行手术治疗的 287 例结直肠癌患者，用于模型评估。
结直肠癌术后 VTE 发生率为 12.0%（65/541）。65 例 VTE 患者中，深静脉血栓（deep vein thrombosis，DVT）占 92.3%（60/65），DVT 合并肺栓塞（pulmonary embolism，PE）占 7.7%（5/65）。多因素分析显示，年龄≥69 岁（<0.01）、术前血浆 D-二聚体≥0.49mg/L（=0.004）、肿瘤分期为Ⅳ期（=0.018）和输血（=0.004）是术后 VTE 的独立危险因素。邵逸夫 VTE RAM 包括上述 4 个因素，总分 4 分，低、中、高危组的评分分别为 0、1 和≥2 分。邵逸夫 VTE RAM 的 ROC 曲线下面积（area under the ROC curve，AUC）为 0.769，Caprini RAM 为 0.656，两者差异有统计学意义（=2.337，=0.0195）。
本研究基于单中心回顾性研究构建了 VTE RAM，该评分表可能适用于中国结直肠癌手术患者。
