Department of Anesthesiology, General Hospital of Ningxia Medical University, Yinchuan, China.
Department of Anesthesiology, Peking University First Hospital Ningxia Women and Children's Hospital (Ningxia Hui Autonomous Region Maternal and Child Health Hospital), PKUFH-NINGXIA Women & Children's Hospital (Maternal and Child Health Hospital of the Autonomous Region), Yinchuan, China.
Clin Appl Thromb Hemost. 2023 Jan-Dec;29:10760296231216966. doi: 10.1177/10760296231216966.
Venous thromboembolism (VTE) is a life-threatening postoperative complication of malignant tumors. We identified risk factors for postoperative VTE in patients undergoing radical resection of colorectal cancer (CRC) and constructed and validated a clinical prediction model. Clinical data of 982 patients undergoing radical resection of CRC from September 1, 2020, to March 31, 2022, in Ningxia Medical University General Hospital were analyzed retrospectively. Patients were randomly divided into training ( = 617) and validation groups ( = 264). Data included baseline characteristics, preoperative complications, examination results, and intraoperative and postoperative indicators. Logistic regression analysis was used to determine risk factors, build a predictive model, and draw a predictive nomogram (CRSPOT). Receiver operating characteristics (ROC) curve was used to calculate the area under the curve (AUC) for evaluating the model's predictive ability. Independent risk factors for postoperative VTE were as follows: postoperative hemoglobin of <10 g/L (odds ratio [OR] 0.413, 95% confidence interval [CI] 0.220-0.777), postoperative D-dimer of ≥3.5μg/mL (OR 2.156, 95% CI 1.145-4.061), BMI of ≥25 kg/m (OR 2.313, 95% CI 1.225-4.369), operation time of ≥4 h (OR 2.292, 95% CI 1.232-4.262), lower extremity varicose veins (OR 4.499, 95% CI 1.764-11.476), postoperative ileus (OR 5.760, 95% CI 2.031-16.337), and postoperative hypoxemia (OR 9.230, 95% CI 4.562-18.672). The nomogram's AUC was 0.826, demonstrating a reliable predictive ability. The CRSPOT nomogram reliably predicts postoperative VTE in patients undergoing radical resection of CRC, identifying high-risk patients early, allowing early implementation of antithrombotic strategies, and helping to reduce the incidence and mortality of postoperative VTE.
静脉血栓栓塞症(VTE)是恶性肿瘤术后危及生命的并发症。我们确定了接受结直肠癌(CRC)根治性切除术患者术后 VTE 的风险因素,并构建和验证了一个临床预测模型。回顾性分析了 2020 年 9 月 1 日至 2022 年 3 月 31 日宁夏医科大学总医院接受结直肠癌根治性切除术的 982 例患者的临床资料。患者被随机分为训练组(n=617)和验证组(n=264)。数据包括基线特征、术前并发症、检查结果以及术中术后指标。采用 logistic 回归分析确定风险因素,建立预测模型,并绘制预测列线图(CRSPOT)。受试者工作特征(ROC)曲线用于计算曲线下面积(AUC),以评估模型的预测能力。术后 VTE 的独立危险因素包括:术后血红蛋白<10g/L(比值比 [OR] 0.413,95%置信区间 [CI] 0.220-0.777)、术后 D-二聚体≥3.5μg/mL(OR 2.156,95%CI 1.145-4.061)、BMI≥25kg/m(OR 2.313,95%CI 1.225-4.369)、手术时间≥4h(OR 2.292,95%CI 1.232-4.262)、下肢静脉曲张(OR 4.499,95%CI 1.764-11.476)、术后肠梗阻(OR 5.760,95%CI 2.031-16.337)和术后低氧血症(OR 9.230,95%CI 4.562-18.672)。该列线图的 AUC 为 0.826,表明具有可靠的预测能力。CRSPOT 列线图可可靠预测接受结直肠癌根治性切除术患者的术后 VTE,早期识别高危患者,早期实施抗血栓策略,有助于降低术后 VTE 的发生率和死亡率。