Risk factors for postoperative venous thromboembolism in patients in department of spinal surgery and construction of predictive model
10.3760/cma.j.cn115682-20211105-04988
- VernacularTitle:脊柱外科患者术后静脉血栓危险因素分析及预测模型构建
- Author:
Tieying QIU
1
;
Suyuan GAO
;
Weixing WANG
;
Jin HUANG
;
Haiyang LI
Author Information
1. 中南大学湘雅二医院临床护理教研室，长沙 410010
- Keywords:
Venous thromboembolism;
Spine surgery;
Risk factors;
Predictive model
- From:
Chinese Journal of Modern Nursing
2022;28(20):2694-2700
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To screen risk factors of postoperative venous thromboembolism (VTE) in patients in department of spinal surgery and establish a risk prediction model and conduct external validation.Methods:This study was a case-control study. Using the convenient sampling method, a total of 93 patients with VTE who underwent spinal surgery from May 2019 to April 2021 in the Second Xiangya Hospital of Central South University were selected as as the thrombosis group, while 100 patients who underwent spinal surgery without VTE during the same period were selected as the control group. A self-designed questionnaire about the risk factors of VTE in patients undergoing spinal surgery was used to investigate the patients. Binomial Logistic regression was used to analyze the risk factors of postoperative VTE in patients with spinal surgery and R software was used to establish a nomogram prediction model. A total of 46 patients (23 patient with VTE and 23 patients without VTE) from Department of Spinal Surgery from May and June 2021 were selected to verify the prediction model.Results:Age ( OR=1.603, 95% CI: 1.036-2.483) , operation time ( OR=0.253, 95% CI: 0.123-0.518) , use of internal fixation ( OR=0.128, 95% CI: 0.043-0.384) , application of bone cement ( OR=0.176, 95% CI: 0.048-0.652) , D-dimer ( OR=0.360, 95% CI: 0.147-0.884) and plasma fibrinogen degradation product ( OR=0.024, 95% CI: 0.006-0.091) were risk factors for VTE in spinal surgery patients. The prediction model was established according to the risk factors. The prediction agreement rate of the model was 0.865 and the sensitivity was 0.742. The model was externally validated with a sensitivity of 0.761, a specificity of 0.565 and an area under the receiver operating characteristic curve of 0.810. Conclusions:Age, operation time, use of internal fixation, application of bone cement, D-dimer and plasma fibrinogen degradation products are risk factors for postoperative VTE in patients with spinal surgery. Predictive models based on risk factors can predict the risk of VTE in spinal surgery patients.
