关键词: 下肢深静脉血栓形成, 头颈部恶性肿瘤, 危险因素, 预测模型

Abstract:

Objective To establish a risk prediction nomogram model associated with perioperative lower extremity deep venous thrombosis (LDVT) in patients with malignant tumor in head and neck. Methods A total of 224 patients diagnosed with malignant tumor in head and neck in Department of Oral and Maxillofacial Surgery of Xuzhou Central Hospital from January 2017 to December 2022 were selected as the research subjects. Based on the occurrence of LDVT, the patients were divided into the developing group (24 cases) and the non-developing group (200 cases). Clinical data of the two groups were collected, and univariate analysis and multivariate Logistic regression analysis were performed to investigate the independent risk factors of perioperative LDVT in patients with malignant tumor in head and neck. At the same time, a risk prediction nomogram model was established and receiver operator characteristic curve (ROC) was drawn to evaluate the prediction efficiency of the nomogram model. Results There were significant differences in hypertension, preoperative anticoagulation, D-dimer level, postoperative bed time and platelet/lymphocyte ratio (PLR) between the two groups (P<0.05). The risk prediction model was constructed based on the independent predictors obtained by multivariate Logistic regression analysis, and the area under the curve (AUC) of the model calculated by the R language software was 0.814 (95% CI:0.778-0.849), with good discrimination and calibration effect. Decision curve analysis confirmed that the net benefit of the prediction model was higher in the threshold probability interval of 10%-75%. Conclusion Establishing a risk prediction model based on hypertension history, preoperative preventive anticoagulation, D-dimer level ≥0.5 mg/L, postoperative bed time ≥3 d and PLR ≥176 can accurately predict the occurrence of perioperative LDVT in patients with malignant tumor in head and neck, which will help to provide individual risk assessment, guide treatment decisions and reduce the occurrence of LDVT complications.

Key words: lower extremity deep venous thrombosis (LDVT), malignant tumor in head and neck, risk factors, prediction model