Construction Of Risk Prediction Model Of Deep Vein Thrombosis In Patients After Posterior Lumbar Fusion

OBJECTIVE:This study analyzed the risk factors of lower extremity deep vein thrombosis after posterior lumbar fusion surgery through the clinical data of patients in order to construct a risk prediction model for lower extremity deep vein thrombosis after posterior lumbar fusion surgery.The aim of this research is to provide a simple and easy tool for spine surgeons to assess the risk of postoperative lower extremity deep vein thrombosis in patients undergoing posterior lumbar fusion surgery,thus enabling early clinical intervention to reduce the incidence of postoperative lower extremity deep vein thrombosis in patients.METHODS:We collected and analyzed the clinical data of patients who underwent posterior lumbar fusion in the Department of Spine Surgery,Qilu Hospital of Shandong University,and divided the patients into DVT and non-DVT groups according to the postoperative ultrasound results.Firstly,we performed statistical analysis on the clinical data to screen out the risk factors,and then the stepwise logistic regression analysis based on the Akaike’s information criterion was performed to construct a prediction model and visualized as nomogram by R.Subsequently,the model was validated with calibration curve,receiver operating characteristic curve,and decision curve analysis.RESULTS:Gender,age,mean arterial pressure,history of hypertension,duration of surgery,and C-reactive protein were independent risk factors for lower extremity deep vein thrombosis in patients after posterior lumbar spine surgery.These six risk factors were included in the model.A prediction model for lower extremity deep vein thrombosis after posterior approach lumbar fusion was constructed and evaluated.The area under the receiver operating characteristic curve was approximately 0.75,which means the prediction model has a moderate predictive efficacy.CONCLUSION:1.In this study,risk factors including:gender,age,mean arterial pressure,history of hypertension,duration of surgery and C-reactive protein were identified,and prophylaxis should be taken to avoid the occurrence of postoperative DVT.2.In this study,a lower extremity deep vein thrombosis after posterior lumbar fusion was constructed.The model was validated to have moderate efficacy and can be used as a clinical predictor of DVT incidence after posterior lumbar fusion.It provides a simple bedside method for clinicians to predict the risk of postoperative DVT and can also provide an evidence-based early intervention for clinicians.