Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, 430030, Hubei, China.
J Thromb Thrombolysis. 2023 Oct;56(3):414-422. doi: 10.1007/s11239-023-02856-0. Epub 2023 Jul 18.
Cancer patients with venous thromboembolism (VTE) are prone to poor prognoses. Thus, we aimed to develop a nomogram to predict the risk of VTE in these patients. We retrospectively analyzed 791 patients diagnosed with solid tumors between January 2017 and May 2021 at Tongji Hospital. Univariate logistic analysis and multivariate logistic regression were adopted in this study. Our results indicated that age ≥ 60 years, tumor stages III-IV, platelet distribution width (PDW) ≤ 12.6%, albumin concentration ≤ 38.8 g/L, lactate dehydrogenase (LDH) concentration ≥ 198 U/L, D-dimer concentration ≥ 1.72 µg/mL, blood hemoglobin concentration ≤ 100 g/dL or the use of erythropoiesis-stimulating agents and cancer types were independent risk factors. The nomogram prediction model was developed based on the regression coefficients of these variables. We assessed the performance of the nomogram by calibration plot and the area under the receiver operating characteristic curve and compared it with the Khorana score. The concordance index (C- index) of the nomogram was 0.852 [95% confidence interval (CI) 0.823 to 0.880], while the Khorana score was 0.681 (95% CI 0.639 to 0.723). Given its performance, this nomogram could be used to select cancer patients at high risk for VTE and guide thromboprophylaxis treatment in clinical practice, provided it is validated in an external cohort.
癌症合并静脉血栓栓塞症（VTE）患者的预后较差。因此，我们旨在开发一种列线图来预测这些患者发生 VTE 的风险。我们回顾性分析了 2017 年 1 月至 2021 年 5 月在同济医院确诊的 791 例实体瘤患者。本研究采用单因素 logistic 分析和多因素 logistic 回归。结果表明，年龄≥60 岁、肿瘤分期 III-IV 期、血小板分布宽度（PDW）≤12.6%、白蛋白浓度≤38.8 g/L、乳酸脱氢酶（LDH）浓度≥198 U/L、D-二聚体浓度≥1.72μg/mL、血红蛋白浓度≤100 g/dL 或使用促红细胞生成素和癌症类型是独立的危险因素。该列线图预测模型是基于这些变量的回归系数建立的。我们通过校准图和受试者工作特征曲线下面积来评估该列线图的性能，并将其与 Khorana 评分进行比较。该列线图的一致性指数（C-指数）为 0.852（95%置信区间 0.823-0.880），而 Khorana 评分的 C-指数为 0.681（95%置信区间 0.639-0.723）。鉴于其性能，该列线图可用于选择 VTE 风险较高的癌症患者，并指导临床实践中的血栓预防治疗，但需要在外部队列中进行验证。
