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Randomized Controlled Trial
. 2023 Jan-Dec:29:10760296231216966.
doi: 10.1177/10760296231216966.

Establishment and Validation of a Postoperative VTE Prediction Model in Patients with Colorectal Cancer Undergoing Radical Resection: CRSPOT Nomogram

Yanan Wu  1 , Lu Wang  1 , Qiaoli Yin  2 , Liqin Deng  1 , Junyang Ma  1 , Xiaoxia Tian  1
Affiliations
Randomized Controlled Trial

Establishment and Validation of a Postoperative VTE Prediction Model in Patients with Colorectal Cancer Undergoing Radical Resection: CRSPOT Nomogram

Yanan Wu et al. Clin Appl Thromb Hemost. 2023 Jan-Dec.

Abstract

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 (n = 617) and validation groups (n = 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/m2 (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.

Keywords: colorectal cancer; nomogram; prediction model; radical resection; venous thromboembolism.

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Conflict of interest statement

Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Flow diagram of study design. BMI, body mass index.
Figure 2.
Figure 2.
(a) Risk factors of BMI, varicose veins, D-dimer, hemoglobin, operative time, hypoxemia, and ileus for nomogram prediction model. (b) Dynamic nomogram used as an example. The significance of the asterisks beside each variable in part b represents importance of all the risk factors.
Figure 3.
Figure 3.
The receiver operating characteristic (ROC) curves for (a) development group and (b) validation group.
Figure 4.
Figure 4.
Calibration curve plot in each group. (a) The development group and (b) the validation group.
Figure 5.
Figure 5.
Decision curve analysis for the nomogram: (a) The development group and (b) the validation group.
See this image and copyright information in PMC

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