Purpose: Venous thromboembolism (VTE) is a common postoperative complication in patients with lung cancer that seriously affects prognosis and quality of life. This study aimed to establish a nomogram for predicting the probability of postoperative VTE risk in patients with stage IA non-small cell lung cancer (NSCLC).Methods: 452 patients with stage IA NSCLC from January 2017 to January 2022 were retrospectively analyzed and randomly divided into a training set and a validation set at a ratio of 7:3.Independent risk factors were identi ed by univariate and multivariate logistic regression analyses, and a nomogram was established based on the results and internally validated. The predictive power of the nomogram was evaluated by receiver operating characteristic curve (ROC), calibration curve, and decision curve analysis (DCA).Results: The nomogram included three risk factors: age, preoperative D-dimer, and intermuscular vein dilatation. The areas under the ROC curve of this model were 0.832 (95% CI: 0.732-0.924) and 0.791 (95% CI: 0.668-0.930) in the training and validation sets, respectively, showing good discriminative power. In addition, the probability of postoperative VTE occurrence predicted by the nomogram was consistent with the actual occurrence probability. In the decision curve, the nomogram had a better net clinical bene t at a threshold probability of 5%-90%.Conclusion: This study is the rst to develop a nomogram for predicting the risk of postoperative VTE in patients with stage IA NSCLC; this nomogram can accurately and intuitively evaluate the probability of VTE in these patients and help clinicians make decisions on prevention and treatment.
Background Venous thromboembolism (VTE) is a common postoperative complication of lung cancer, but the incidence and risk stratification of postoperative VTE in stage IA non‐small‐cell lung cancer (NSCLC) patients remains unclear, therefore we conducted a single‐center prospective study. Methods A total of 314 consecutive patients hospitalized for lung cancer surgery and diagnosed with stage IA NSCLC from January 2017 to July 2021 were included. The patients were divided into the VTE group and the non‐VTE group according to whether VTE occurred after the operation. The patient's age, operation time, D‐dimer (D‐D) value, tumor pathology, and Caprini score were recorded. The different items were compared and included in logistic regression analysis to obtain independent risk factors, and the area under the receiver operating characteristics curve (AUC) was calculated. Results The incidence of VTE was 7.3%. Significant differences in age, operation time, preoperative and postoperative day 1 D‐D value, neuron‐specific enolase value, forced expiratory volume in 1 second, maximum ventilation, carbon monoxide diffusion capacity, and pathological diameter were noted between the two groups. Age (95% confidence interval [CI] 1.056–1.216) and postoperative day 1 D‐D value (95% CI 1.125–1.767) were independent risk factors. The incidence of VTE in the low‐, medium‐, and high‐risk groups with Caprini scores was 0%, 7.3%, and 11.5%, respectively. The AUC of the Caprini score was 0.704 (p < 0.05). Conclusions The incidence of postoperative VTE in patients with stage IA NSCLC was 7.3%. Age and postoperative day 1 D‐D value were independent risk factors for VTE. The Caprini score has a certain value in the diagnosis of postoperative VTE of stage IA NSCLC.
Background Venous thromboembolism (VTE) is a common postoperative complication in general thoracic surgery, but the incidence of patients undergoing surgery for bronchiectasis was not known. The purpose of our study was to investigate the incidence of VTE in bronchiectasis patients undergoing lung resection and to evaluate the risk stratification effect of the modified caprini risk assessment model (RAM). Methods We prospectively enrolled patients with bronchiectasis who underwent lung resection surgery between July 2016 and July 2020.The postoperative duplex lower-extremity ultrasonography or(and) computed tomographic pulmonary angiography (CTPA) was performed to detect VTE. The clinical characteristics and caprini scores of VTE patients and non-VTE patients would be compared and analyzed. Univariate logistic regression was performed to evaluate whether higher Caprini scores were associated with postoperative VTE risk.In addition, We explored the optimal cutoff for caprini score in patients with bronchiectasis by using the receiver operating characteristic (ROC) curve. Results One hundred and seventeen patients were eligible based on the prospective study criteria. The postoperative VTE incidence was 8.5% (10/117). By comparing the clinical characteristics and Caprini scores of VTE and non-VTE patients, the median preoperative hospitalization (7 vs 5 days, P = 0.028) and Caprini score (6.5 vs 3,P < 0.001) were significantly higher in VTE patients. In univariate logistic regression, a higher Caprini score was associated with higher odds ratio (OR) for VTE of 1.7, 95% confidence interval (CI) was from 1.2 to 2.5 (P = 0.001), C-statistics was 0.815 in the modified caprini RAM for predicting VTE. In a multivariable analysis adjusting for preoperative hospitalization, a higher Caprini score was associated with higher odds OR for VTE of 1.8 (95%CI: 1.2–2.6, P = 0.002), C-statistics was 0.893 in the caprini RAM for predicting VTE. When taking the Caprini score as 5 points as the diagnostic threshold, the Youden index is the largest. Conclusions The postoperative VTE incidence in patients undergoing lung resection for bronchiectasis was 8.5%.The modified caprini RAM effectively stratified bronchiectasis surgery patients for risk of VTE and showed excellent predictive power for VTE. The patients with postoperative caprini scores = 5, should be recommended to take positive measures to prevent postoperative VTE. Trial Registration Chinese Clinical Trial Register: ChiCTR-EOC-17010577.
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