Clinical Characteristics And Risk Factors Of Postoperative Thrombosis In Patients With Lung Cancer Predicted By Modified Caprini Risk Assessment Scale

Objective:To explore the clinical characteristics of modified Caprini RAM in predicting thrombosis after lung cancer surgery,analysis the high-risk factors of its occurrence,to clarify the mechanism of VTE after lung cancer surgery,and provide experimental evidence and new ideas for the prevention and treatment of VTE after lung cancer surgery.Methods:.A prospective study of patients with resectable lung cancer who were admitted by the Thoracic Surgery Department of the First Affiliated Hospital of Chongqing Medical University from October 2019 to October2020.Modified Caprini RAM was used to evaluate the VTE of patients after lung cancer and analyz the perioperative period.Phase related clinical data,and logistic analysis of high-risk factors for VTE events in patients with resectable lung cancer.Results:1.A total of 462 patients were enrolled in the group,including 16 cases in the low-risk group with modified Caprini score,428 cases in the middle-risk group,and 18 cases in the high-risk group;44 cases in the VTE group,including 39 cases in the middle-risk group with modified Caprini score and 5 cases in the high-risk group;40 cases were diagnosed as DVT,including 37 cases in the intermediate-risk group and 3 cases in the high-risk group;4 cases were diagnosed as PE,including 2 in the intermediate-risk group and 2 in the high-risk group example.There were438 cases in the VTE-free group,including 16 cases in the low-risk group,389 cases in the intermediate-risk group,and 13 cases in the high-risk group.2.When the modified Caprini score ≥ 5 points,the AUC for predicting VTE after lung cancer surgery is 0.740 [95% CI(0.657,0.763)],the best cut-off value is 5.5 points,the Youden index is 0.402,and its sensitivity is90.9%,which is specific The degree is 49.3%.3.The results of statistical analysis of clinical data showed that the age of lung cancer patients in the VTE group and the non-VTE group,the preoperative Hb level,operation time,intraoperative blood loss,postoperative blood transfusion,postoperative bed time,postoperative D-D and postoperative FDP are statistically different(P < 0.05),and the preoperative increase in Hb level is the result of postoperative VTE in lung cancer patients The preoperative Hb level predicts postoperative VTE event AUC of 0.645[95%CI(0.516,0.774)],the best cut-off value is 145.5g/L,the sensitivity is 63.6%,and the specificity is 32.5 %.Conclusion:1.The modified Caprini RAM can effectively predict the occurrence of VTE in patients with resectable lung cancer.2.Advanced age,increased preoperative Hb,prolonged operation time,increased intraoperative blood loss,postoperative blood transfusion,prolonged postoperative bed time,postoperative D-dimer,and FDP increase are the high risk of postoperative VTE events in lung cancer patients Factors,and an independent risk factor for postoperative VTE in lung cancer patients when the preoperative Hb level is elevated.Therefore,prevention and intervention of these factors in the perioperative period of lung cancer patients can effectively reduce the incidence of postoperative VTE.