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胸腔镜肺叶切除术后患者术后静脉血栓栓塞症的危险因素分析。

Risk Factor Analysis of Postoperative Venous Thromboembolism in Patients After Thoracoscopic Lobectomy.

机构信息

Department of Thoracic Surgery, 117858Dongyang People's Hospital, Dongyang City, China.

出版信息

Clin Appl Thromb Hemost. 2023 Jan-Dec;29:10760296231156908. doi: 10.1177/10760296231156908.

Abstract

OBJECTIVE

To analyze independent risk factors for postoperative venous thromboembolism (VTE) in patients after thoracoscopic lobectomy and establish a risk model for predicting thrombosis.

METHODS

We selected 135 patients who underwent thoracoscopic lobectomy and assigned them to a VTE group ( = 31) and a non-VTE group ( = 104) according to the presence or absence of postoperative VTE. Univariate and multivariate logistic regression models were built to identify independent risk factors for postoperative thrombosis. A nomogram to predict the risk of thrombosis was generated, with the predictive performance of the model being evaluated by plotting calibration curve and the receiver operating characteristic (ROC) curve.

RESULTS

D-dimer on the first postoperative day and Caprini scores were independent high-risk factors for VTE after thoracoscopic lobectomy as revealed by univariate and multivariate logistic regression analyses (< .05). The nomogram was evaluated, and the fitting degree of calibration curve indicated good accuracy of the model in predicting thrombosis. The area under the curve (AUC) value was 0.8654, suggesting favorable diagnostic efficacy of the model.

CONCLUSION

The D-dimer on the first postoperative day and Caprini scores were independent risk factors for VTE after thoracoscopic lobectomy. The nomogram that was generated to predict the risk of thrombosis had good accuracy and diagnostic efficacy, which can guide individual risk assessment and management decisions in clinical practice.

摘要

目的

分析胸腔镜肺叶切除术后患者术后静脉血栓栓塞症(VTE)的独立危险因素,并建立血栓预测风险模型。

方法

选取 135 例行胸腔镜肺叶切除术的患者,根据术后是否发生 VTE 将其分为 VTE 组(n=31)和非 VTE 组(n=104)。采用单因素和多因素逻辑回归模型筛选术后血栓形成的独立危险因素。生成预测血栓形成风险的列线图,并通过绘制校准曲线和受试者工作特征(ROC)曲线评估模型的预测性能。

结果

单因素和多因素逻辑回归分析显示,术后第 1 天 D-二聚体和 Caprini 评分是胸腔镜肺叶切除术后 VTE 的独立高危因素(<0.05)。该列线图具有良好的拟合度,校准曲线提示模型对血栓形成的预测准确性较高。曲线下面积(AUC)值为 0.8654,提示模型具有良好的诊断效能。

结论

术后第 1 天 D-二聚体和 Caprini 评分是胸腔镜肺叶切除术后 VTE 的独立危险因素。该列线图预测血栓形成风险的准确性和诊断效能良好,可指导临床实践中的个体风险评估和管理决策。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/91ea/9926371/23c0b1d3c9e2/10.1177_10760296231156908-fig1.jpg

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