Establishment and Validation of a Postoperative VTE Prediction Model in Patients with Colorectal Cancer Undergoing Radical Resection: CRSPOT Nomogram

Abstract

Venous thromboembolism (VTE) is a life-threatening postoperative complication of malignant tumors. We identified risk factors for postoperative VTE in patients undergoing radical resection of colorectal cancer (CRC) and constructed and validated a clinical prediction model. Clinical data of 982 patients undergoing radical resection of CRC from September 1, 2020, to March 31, 2022, in Ningxia Medical University General Hospital were analyzed retrospectively. Patients were randomly divided into training ( n = 617) and validation groups ( n = 264). Data included baseline characteristics, preoperative complications, examination results, and intraoperative and postoperative indicators. Logistic regression analysis was used to determine risk factors, build a predictive model, and draw a predictive nomogram (CRSPOT). Receiver operating characteristics (ROC) curve was used to calculate the area under the curve (AUC) for evaluating the model's predictive ability. Independent risk factors for postoperative VTE were as follows: postoperative hemoglobin of <10 g/L (odds ratio [OR] 0.413, 95% confidence interval [CI] 0.220–0.777), postoperative D-dimer of ≥3.5μg/mL (OR 2.156, 95% CI 1.145–4.061), BMI of ≥25 kg/m2 (OR 2.313, 95% CI 1.225–4.369), operation time of ≥4 h (OR 2.292, 95% CI 1.232–4.262), lower extremity varicose veins (OR 4.499, 95% CI 1.764–11.476), postoperative ileus (OR 5.760, 95% CI 2.031–16.337), and postoperative hypoxemia (OR 9.230, 95% CI 4.562–18.672). The nomogram's AUC was 0.826, demonstrating a reliable predictive ability. The CRSPOT nomogram reliably predicts postoperative VTE in patients undergoing radical resection of CRC, identifying high-risk patients early, allowing early implementation of antithrombotic strategies, and helping to reduce the incidence and mortality of postoperative VTE.