食管癌术后静脉血栓栓塞症风险预测模型的构建及验证
Construction and verification of risk prediction model for venous thromboembolism after esophageal cancer surgery
曹娟 1李方 1于跃 1戴丽 1杨丹丹 1李志华 1徐欣怡 2戴琪 1陈柯宇1
作者信息
- 1. 南京医科大学第一附属医院 胸外科,江苏 南京 210029
- 2. 南京医科大学 护理学院,江苏 南京 211166
- 折叠
摘要
目的 构建食管癌患者术后静脉血栓栓塞症风险预测模型.方法 采用便利抽样选取 2020年 1月-2022年 4月在某三级甲等医院行食管静脉血栓栓塞症癌根治术的 220例患者作为建模组,分为静脉血栓栓塞症组 60例和非静脉血栓栓塞症组 160例.采用Logistic回归分析建立食管癌患者术后静脉血栓栓塞症风险预测模型并对模型验证.结果 年龄≥60岁、基础疾病、新辅助化疗、手术时长、术后使用凝血酶原复合物(prothrombin complex concentrates,PCC)、术后 12 h D-D是食管癌患者术后静脉血栓栓塞症危险因素.HL检验P=0.250,受试者工作曲线特征曲线下面积(area under curve,AUC)为 0.766,最佳临界值为 0.445,灵敏度为 0.783,特异度为0.662.验证组AUC为0.738,灵敏度为 0.682,特异度为 0.769,正确率为 80.0%.结论 该预测模型的预测效果良好,可为临床评估食管癌患者术后静脉血栓栓塞症发生风险提供参考.
Abstract
Purpose To construct a venous thromboembolism(VTE)risk prediction model for postoperative patients with esophageal cancer.Methods Convenience sampling was used to select 220 patients who underwent esophageal cancer surgery in a tertiary grade-A hospital from January 2020 to April 2022 as the modeling group,with 60 in the VTE group and 160 in the non-VTE group.Logistic regression analysis was used to establish the VTE risk prediction model,which was validated by a separate validation group.Results Risk factors for postoperative VTE in patients with esophageal cancer included age≥60 years,comorbidities,neoadjuvant chemotherapy(NACT),operative duration,postoperative use of prothrombin complex concentrates(PCC),and postoperative D-D at 12 hours.The model showed good predictive accuracy.In the modeling group,HL test showed P=0.250,area under receiver operating characteristic curve(AUC)was 0.766,the best cutoff value was 0.445,the sensitivity was 0.783,the specificity was 0.662.In the validation group,AUC was 0.738,the sensitivity was 0.682,the specificity was 0.769,the prediction accuracy was 80%.Conclusion The prediction model has demonstrated good predictive performance and can provide reference for assessing VTE risk in postoperative patients with esophageal cancer.
关键词
食管癌/静脉血栓栓塞症/风险预测/影响因素/列线图Key words
esophageal cancer/venous thromboembolism/risk prediction/influencing factor/nomogram引用本文复制引用
基金项目
国家自然科学基金(81902453)
江苏省人民医院临床能力提升工程项目(JSPH-NC-2021-22)
出版年
2024
国家科技期刊平台
NSTL
万方数据