Analysis of risk factors associated with lower extremity venous thromboembolism after transurethral resection of prostate
10.3760/cma.j.cn115396-20230425-00108
- VernacularTitle:经尿道前列腺电切术后并发下肢静脉血栓栓塞的相关危险因素分析
- Author:
Feifei SONG
1
;
Di ZHANG
;
Rui SHI
Author Information
1. 首都医科大学附属北京友谊医院泌尿外科，北京 100050
- Keywords:
Prostatic hyperplasia;
Venous thromboembolism;
Nomograms;
Transurethral resection of prostate
- From:
International Journal of Surgery
2023;50(10):658-664
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the risk factors of lower extremity venous thromboembolism (VTE) after transurethral resection of prostate (TURP) in patients with prostatic hyperplasia.Methods:The clinical data of 464 patients with prostatic hyperplasia who underwent TURP in Beijing Friendship Hospital, Capital Medical University from July 2018 to August 2022 were collected retrospectively. Including basic information, prostate volume, operation time, Caprini score, plasma D-dimer level, postoperative complications and so on. They were divided into two groups according to whether lower extremity VTE occurs: VTE group ( n=25) and non-VTE group ( n=439). The potential risk factors of lower extremity VTE were determined by univariate analysis and multivariate Logistic regression analysis, the risk prediction model was established, and the nomogram was drawn, the internal verification of Bootstrap was carried out, the correction curve was made, and the prediction ability of the model was verified by consistency index (C-index) and R2. Results:Among 464 patients, the incidence of lower extremity VTE was 5.4% (25/464). A total of 1.9% of the patients were diagnosed with deep venous thromboembolism and no pulmonary thromboembolism occurred. There were significant differences in Caprini score, operation time, age, diabetes, smoking history and previous thrombus history between VTE group and non-VTE group. Univariate analysis showed that age, operation time, Caprini score, history of diabetes, smoking and previous history of thrombosis may be the risk factors of postoperative lower extremity VTE. Multivariate Logistic regression analysis showed that operation time ( OR=37.429, P=0.001) and Caprini score ( OR=3.306, P<0.001) were independent risk factors for postoperative lower extremity VTE. The risk of postoperative lower extremity VTE in patients with less than 60 minutes of operation was significantly lower than that in patients with more than 90 minutes ( OR=0.024, P<0.001), and the risk of postoperative lower extremity VTE in patients with Caprini scores of 4 and 5 was significantly lower than that of patients with 7 points ( OR=0.041 and 0.082, P=0.004 and 0.003). The nomogram was drawn according to the results of multivariate Logstic regression analysis. After internal verification, it was suggested that the nomogram has better prediction ability, C-index was 0.935, 95% CI: 0.906-0.965, R2 was 0.451. Conclusions:Caprini score and operation time are independent risk factors for lower extremity VTE after TURP of patients with prostatic hyperplasia. The nomogram model including operation time and Caprini score has good predictive efficiency and can help medical staff to predict the risk of lower extremity VTE after TURP.
