The Third Central Clinical College of Tianjin Medical University, Tianjin, China (mainland).
Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, Tianjin, China (mainland).
Med Sci Monit. 2023 Dec 17;29:e942087. doi: 10.12659/MSM.942087.
BACKGROUND Lower extremity deep vein thrombosis (LEDVT), a common postoperative breast cancer complication, depends on multiple factors, such as systemic inflammation and immune status. We assessed the preoperative systemic immune-inflammatory index (SII) as a LEDVT risk predictor and did stratified nursing intervention based on it. MATERIAL AND METHODS A retrospective analysis was conducted on 552 patients who underwent breast cancer surgery from January 2019 to May 2020. Univariate and multivariate methods were used to screen independent risk factors for postoperative LEDVT, and effects of risk stratification and nursing intervention on the validation cohort were observed. RESULTS A total of 46 patients (8.3%) developed postoperative LEDVT. Compared with the control group, the LEDVT group had older age, higher proportion of menopause, higher preoperative Autar score, SII, and plasma D-dimer level, lower albumin level, and later postoperative pathological stage, with statistically significant differences (P<0.05). Multivariate logistic regression showed SII, plasma D-dimer, and menopause were independent predictors of postoperative LEDVT. ROC curve analysis showed SII had the strongest predictive ability, with an AUC of 0.714. Subsequently, 126 patients in the validation set were stratified according to the preoperative SII score, and intensified nursing intervention was implemented for high-risk patients, resulting in a significant reduction in the incidence of LEDVT (3.3% vs 8.3%, P=0.046). CONCLUSIONS Preoperative SII level can be used as an independent risk predictor of postoperative LEDVT in breast cancer patients. Applying it for risk stratification and implementing intensified nursing intervention for high-risk patients can significantly reduce the incidence of postoperative LEDVT.
下肢深静脉血栓形成（LEDVT）是乳腺癌术后常见的并发症，其发生取决于多种因素，如全身炎症和免疫状态。我们评估了术前全身免疫炎症指数（SII）作为 LEDVT 的风险预测因子，并根据其进行了分层护理干预。
回顾性分析了 2019 年 1 月至 2020 年 5 月接受乳腺癌手术的 552 例患者。采用单因素和多因素方法筛选术后 LEDVT 的独立危险因素，并观察风险分层和护理干预对验证队列的影响。
共有 46 例（8.3%）患者发生术后 LEDVT。与对照组相比，LEDVT 组年龄较大，绝经比例较高，术前 Autar 评分、SII 和血浆 D-二聚体水平较高，白蛋白水平较低，术后病理分期较晚，差异均有统计学意义（P<0.05）。多因素 logistic 回归分析显示，SII、血浆 D-二聚体和绝经是术后 LEDVT 的独立预测因子。ROC 曲线分析显示，SII 具有最强的预测能力，AUC 为 0.714。随后，在验证组中，根据术前 SII 评分对 126 例患者进行分层，并对高危患者实施强化护理干预，显著降低了 LEDVT 的发生率（3.3%比 8.3%，P=0.046）。
术前 SII 水平可作为乳腺癌患者术后 LEDVT 的独立危险因素。应用其进行风险分层，并对高危患者实施强化护理干预，可显著降低术后 LEDVT 的发生率。
