Development and validation of a multi-parameter nomogram for venous thromboembolism in gastric cancer patients: a retrospective analysis

Abstract

Objective Gastric cancer (GC), one of the highest venous thromboembolism (VTE) incidence rates in cancer, contributes to considerable morbidity, mortality, and, prominently, extra cost. However, up to now, there is not a high-quality VTE model to steadily predict the risk for VTE in China. Consequently, setting up a prediction model to predict the VTE risk is imperative. Methods Data from 3,092 patients from December 15, 2017, to December 31, 2022, were retrospectively analyzed. Multiple logistic regression analysis was performed to assess risk factors for GC, and a nomogram was constructed based on screened risk factors. A receiver operating curve (ROC) and calibration plot was created to evaluate the accuracy of the nomogram. Results The risk factors of suffering from VTE were older age (OR = 1.02, 95% CI [1.00–1.04]), Karnofsky Performance Status (KPS) ≥ 70 (OR = 0.45, 95% CI [0.25–0.83]), Blood transfusion (OR = 2.37, 95% CI [1.47–3.84]), advanced clinical stage (OR = 3.98, 95% CI [1.59–9.99]), central venous catheterization (CVC) (OR = 4.27, 95% CI [2.03–8.99]), operation (OR = 2.72, 95% CI [1.55–4.77]), fibrinogen degradation product (FDP) >5 µg/mL (OR = 1.92, 95% CI [1.13–3.25]), and D-dimer > 0.5 mg/L (OR = 2.50, 95% CI [1.19–5.28]). The area under the ROC curve (AUC) was 0.82 in the training set and 0.85 in the validation set. Conclusion Our prediction model can accurately predict the risk of the appearance of VTE in gastric cancer patients and can be used as a robust and efficient tool for evaluating the possibility of VTE.