Qin Da, Cai Hongfei, Liu Qing, Lu Tianyu, Tang Ze, Shang Yuhang, Cui Youbin, Wang Rui
Department of Thoracic Surgery, The First Hospital of Jilin University, Changchun, China.
Organ Transplantation Center, The First Hospital of Jilin University, Changchun, China.
Front Physiol. 2023 Dec 14;14:1242132. doi: 10.3389/fphys.2023.1242132. eCollection 2023.
The aim of this study was to develop a nomogram model in combination with thromboelastography (TEG) to predict the development of venous thromboembolism (VTE) after lung cancer surgery. The data of 502 patients who underwent surgical treatment for lung cancer from December 2020 to December 2022 were retrospectively analyzed. Patients were then randomized into training and validation groups. Univariate and multivariate logistic regression analyses were carried out in the training group and independent risk factors were included in the nomogram to construct risk prediction models. The predictive capability of the model was assessed by the consistency index (C-index), receiver operating characteristic curves (ROC), the calibration plot and decision curve analysis (DCA). The nomogram risk prediction model comprised of the following five independent risk factors: age, operation time, forced expiratory volume in one second and postoperative TEG parameters k value(K) and reaction time(R). The nomogram model demonstrated better predictive power than the modified Caprini model, with the C-index being greater. The calibration curve verified the consistency of nomogram between the two groups. Furthermore, DCA demonstrated the clinical value and potential for practical application of the nomogram. This study is the first to combine TEG and clinical risk factors to construct a nomogram to predict the occurrence of VTE in patients after lung cancer surgery. This model provides a simple and user-friendly method to assess the probability of VTE in postoperative lung cancer patients, enabling clinicians to develop individualized preventive anticoagulation strategies to reduce the incidence of such complications.
本研究旨在结合血栓弹力图(TEG)开发一种列线图模型,以预测肺癌手术后静脉血栓栓塞症(VTE)的发生。回顾性分析了2020年12月至2022年12月期间接受肺癌手术治疗的502例患者的数据。然后将患者随机分为训练组和验证组。在训练组中进行单因素和多因素逻辑回归分析,并将独立危险因素纳入列线图以构建风险预测模型。通过一致性指数(C指数)、受试者工作特征曲线(ROC)、校准图和决策曲线分析(DCA)评估模型的预测能力。列线图风险预测模型由以下五个独立危险因素组成:年龄、手术时间、一秒用力呼气量以及术后TEG参数k值(K)和反应时间(R)。列线图模型显示出比改良Caprini模型更好的预测能力,C指数更高。校准曲线验证了两组列线图之间的一致性。此外,DCA证明了列线图的临床价值和实际应用潜力。本研究首次将TEG与临床危险因素相结合构建列线图,以预测肺癌手术后患者VTE的发生。该模型提供了一种简单且用户友好的方法来评估肺癌术后患者发生VTE的概率,使临床医生能够制定个体化的预防性抗凝策略,以降低此类并发症的发生率。