Application value of decision tree model in risk prediction of venous thrombosis after laparoscopic rectal cancer surgery
10.3760/cma.j.cn115807-20240720-00245
- VernacularTitle:决策树模型在腹腔镜直肠癌术后静脉血栓形成风险预测中的应用价值
- Author:
Yan CAO
1
;
Yaguang FENG
1
;
Zhanwei DING
1
Author Information
1. 商丘市第一人民医院胃肠外科，商丘 476100
- Publication Type:Journal Article
- Keywords:
Rectal cancer;
Venous thrombosis;
Laparoscopic radical resection of rectal cancer;
Decision tree model
- From:
Chinese Journal of Endocrine Surgery
2024;18(6):881-886
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the application value of decision tree model in predicting the risk of venous thrombosis (VTE) after laparoscopic rectal cancer surgery.Methods:A prospective study was conducted to select 150 patients with rectal cancer admitted to the hospital from Feb. 2022 to Feb. 2024 as the study subjects. All patients underwent laparoscopic radical resection of rectal cancer. According to the occurrence of VTE within 1 month after operation, they were divided into VTE group and non-VTE group. The baseline data and laboratory indexes of the two groups were statistically analyzed and compared. Binary logistic regression was used to analyze the influencing factors of VTE in patients with rectal cancer after laparoscopic surgery, and a decision tree model was constructed. The receiver operating curve (ROC) was used to evaluate the value of the decision tree model in predicting the occurrence of VTE in patients with rectal cancer after laparoscopic surgery.Results:There were 26 cases of VTE in 152 patients with rectal cancer within 7 days after laparoscopic surgery, with an incidence of 17.11% (26/152). The operation time and postoperative immobilization time in the VTE group were longer than those in the VTE free group. The intraoperative gas abdominal pressure was higher than that in the VTE free group. The proportion of perioperative infection, past VTE history, blood transfusion, and patients with diabetes was higher than that without VTE ( P<0.05). The levels of PLT and D-D in the VTE group were higher than those in the non VTE group ( P<0.05). The levels of PLT and D-D in the VTE group were higher than those in the non-VTE group ( OR>1, P<0.05). According to the decision tree, intraoperative pneumoperitoneum pressure, D-D level and blood transfusion were independent risk factors, among which intraoperative pneumoperitoneum pressure had the most significant effect. ROC results showed that the AUC of the decision tree model for predicting VTE after laparoscopic surgery in patients with rectal cancer was 0.910 (95% CI:0.861-0.960), the specificity was 0.731, the sensitivity was 0.857, and the Youden index was 0.588. Conclusions:High intraoperative pneumoperitoneum pressure, long postoperative braking time, previous history of VTE, blood transfusion and high expression of PLT and D-D in serum are the influencing factors of VTE in patients with rectal cancer after laparoscopic surgery. Based on the above factors, the decision tree model can effectively predict the risk of postoperative VTE in patients.
