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Incidence, prevention, risk factors, and prediction of venous thromboembolism in chinese patients after colorectal cancer surgery: a prospective, multicenter cohort study

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作者：
Wei Qi[1] ; Wei Zheng-Qiang[2] ; Jing Chang-Qing[3] ; Li Yong-Xiang[4] ; Zhou Dong-Bing[5] ; Lin Mou-Bin[6] ; He Xian-Li[7] ; Li Fan[8] ; Liu Qian[9] ; Zheng Jian-Yong[10] ; Wang Gui-Ying[11] ; Tu Shi-Liang[12] ; Wang Zhen-Jun[13] ; Li Ang[14] ; Xiao Gang[15] ; Zhuang Jing[16] ; Bai Lian[17] ; Huang He[18] ; Li Yong[19] ; Song Wu[20] ; Liang Zhong-Lin[21] ; Shen Zhan-Long[22] ; Liu Fan-Long[23] ; Dai Yong[24] ; Zhou Xiao-Jun[25] ; Dong Ming[26] ; Wang Hui[27] ; Qiu Jian[28] ; Zhou Lei[29] ; Li Xin-Xiang[30] ; Wang Zi-Qiang[31] ; Zhang Hong[32] ; Wang Quan[33] ; Pang Ming-Hui[34] ; Wei Hong-Bo[35] ; Hu Zhi-Qian[36] ; Yan Yi-Dan[37] ; Che Yan[38] ; Gu Zhi-Chun[37,*2] ; Yao Hong-Wei[1,*1] ; Zhang Zhong-Tao[1,*1] ;
机构： [1]Department of General Surgery, Beijing Friendship Hospital, Capital Medical University, National Clinical Research Center of Digestive Diseases, Beijing 100050, People's Republic of China. [2]Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, People's Republic of China. [3]Department of Gastrointestinal Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, Shandong Province, People's Republic of China. [4]Department of General Surgery, First Affiliated Hospital of Anhui Medical University Hefei 230000, Anhui Province, People's Republic of China. [5]Department of Gastrointestinal Surgery, The Affiliated Nanchong Central Hospital of North Sichuan Medical College, Nanchong 637003, Sichuan Province, People's Republic of China. [6]Department of General Surgery, Yangpu Hospital, Tongji University School of Medicine, Shanghai 200090, People's Republic of China. [7]Department of General Surgery, Tangdu Hospital, The Air Force Medical University, Xi'an 710038, Shannxi Province, People's Republic of China. [8]Department of General Surgery, Daping Hospital, Army Medical University, Chongqing 400042, People's Republic of China. [9]Department of Colorectal Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, People's Republic of China. [10]Department of Gastrointestinal Surgery, The First Affiliated Hospital of Air Force Military Medical University, Xi'an 710032, Shaanxi Province, People's Republic of China. [11]Department of General Surgery, The Second Hospital of Hebei Medical University, Shijiazhuang 050011, Hebei Province, People's Republic of China. [12]General Surgery, Cancer Center, Department of Colorectal Surgery, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou 310014, Zhejiang Province, People's Republic of China. [13]Department of General Surgery, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, People's Republic of China. [14]Department of General Surgery, Xuanwu hospital Capital Medical University, Beijing 100053, People's Republic of China. [15]Department of Gastrointestinal Surgery, Beijing Hospital, National Center of Gerontology, Beijing 100730, People's Republic of China. [16]Department of General Surgery, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou 450008, Henan Province, People's Republic of China. [17]Department of Gastrointestinal Surgery, Yongchuan hospital of Chongqing Medical university, Chongqing 402160, People's Republic of China. [18]Department of Gastrointestinal surgery, The First Hospital of Shanxi Medical University, Taiyuan 030000, Shanxi Province, People's Republic of China. [19]Department of Gastrointestinal Surgery, Department of General Surgery, Guangdong Provincial People's Hospital, Guangzhou 510080, Guangdong Province, People's Republic of China. [20]Department of Gastrointestinal Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, Guangdong Province, People's Republic of China. [21]Department of Colorectal and Anal Surgery, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200092, People's Republic of China. [22]Department of Gastroenterological Surgery, Peking University People's Hospital, Beijing 100044, People's Republic of China. [23]First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310006, Zhejiang Province, People's Republic of China. [24]Department of General Surgery, Qilu Hospital of Shandong University, Jinan 250012, Shandong Province, People's Republic of China. [25]Department of General Surgery, First Affiliated Hospital of Soochow University, Soochow 215006, Jiangsu Province, People's Republic of China. [26]Department of Gastrointestinal Surgery, The First Hospital of China Medical University, Shenyang 110001, Liaoning Province, People's Republic of China. [27]Department of Colorectal Surgery, The Sixth Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510655, Guangdong Province, People's Republic of China. [28]Department of General Surgery, Shaanxi Provincial People's Hospital, Xi'an 710068, Shaanxi Province, People's Republic of China. [29]Department of General Surgery, China-Japan Friendship Hospital, Beijing 100029, People's Republic of China. [30]Department of Colorectal Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, People's Republic of China. [31]Colorectal Cancer Center, Department of General Surgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, People's Republic of China. [32]Department of Colorectal Oncology, Fourth General Surgery Department, Shengjing Hospital, China Medical University, Shenyang 110000, Liaoning Province, People's Republic of China. [33]Department of Gastric and Colorectal Surgery, General Surgery Center, The First Hospital of Jilin University, Changchun 130021, Jilin Province, People's Republic of China. [34]Department of Geriatric Surgery [35]Department of Gastrointestinal Surgery, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu 610072, Sichuan Province, People's Republic of China. [35]Department of Gastrointestinal Surgery, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, Guangdong Province, People's Republic of China. [36]Department of Gastrointestinal Surgery, Tongji Hospital, Medical College of Tongji University, Shanghai 200065, People's Republic of China. [37]Department of Pharmacy, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, People's Republic of China. [38]NHC Key Lab of Reproduction Regulation, Shanghai Institute for Biomedical and Pharmaceutical Technologies, Shanghai 200237, People's Republic of China.
出处：
DOI： 10.1097/JS9.0000000000000553
ISSN：

关键词： venous thromboembolism colorectal cancer prophylaxis risk factors prediction model

摘要：
Venous thromboembolism (VTE) is a common and serious complication after colorectal cancer (CRC) surgery. Few large-sample studies have reported VTE incidence and management status after CRC surgery in China. This study aimed to investigate the incidence and prevention of VTE in Chinese patients after CRC surgery, identify risk factors for developing VTE, and construct a new scoring system for clinical decision-making and care planning.Participants were recruited from 46 centers in 17 provinces in China. Patients were followed up for one month postoperatively. The study period was from May 2021 to May 2022. The Caprini score risk stratification and VTE prevention and incidence were recorded. The predictors of the occurrence of VTE after surgery were identified by multivariate logistic regression analysis, and a prediction model (CRC-VTE score) was developed.A total of 1,836 patients were analyzed. The postoperative Caprini scores ranged from 1 to 16 points, with a median of 6 points. Of these, 10.1% were classified as low risk (0-2 points), 7.4% as moderate risk (3-4 points), and 82.5% as high risk (≥5 points). Among these patients, 1,210 (65.9%) received pharmacological prophylaxis, and 1,061 (57.8%) received mechanical prophylaxis. The incidence of short-term VTE events after CRC surgery was 11.2% (95%CI 9.8-12.7), including deep venous thrombosis (DVT) (11.0%, 95%CI 9.6-12.5) and pulmonary embolism (PE) (0.2%, 95%CI 0-0.5). Multifactorial analysis showed that age (≥70 y), history of varicose veins in the lower extremities, cardiac insufficiency, female sex, preoperative bowel obstruction, preoperative bloody/tarry stool, and anesthesia time ≥180 minutes were independent risk factors for postoperative VTE. The CRC-VTE model was developed from these seven factors and had good VTE predictive performance (C-statistic 0.72, 95%CI 0.68-0.76).This study provided a national perspective on the incidence and prevention of VTE after CRC surgery in China. The study offers guidance for VTE prevention in patients after CRC surgery. A practical CRC-VTE risk predictive model was proposed.Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.

基金：
XXX.
语种：
外文
被引次数：
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PubmedID：
中科院(CAS)分区：
出版当年[2023]版：
大类 | 2 区 医学
小类 | 2 区 外科
最新[2023]版：
大类 | 2 区 医学
小类 | 2 区 外科
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出版当年[2023]版：
Q1 SURGERY
最新[2023]版：
Q1 SURGERY

影响因子： 最新[2023版] 最新五年平均 出版当年[2023版] 出版当年五年平均 出版前一年[2022版]

第一作者：
第一作者机构： [1]Department of General Surgery, Beijing Friendship Hospital, Capital Medical University, National Clinical Research Center of Digestive Diseases, Beijing 100050, People's Republic of China.
共同第一作者：
通讯作者：
通讯机构： [1]Department of General Surgery, Beijing Friendship Hospital, Capital Medical University, National Clinical Research Center of Digestive Diseases, Beijing 100050, People's Republic of China. [37]Department of Pharmacy, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, People's Republic of China. [*1]Department of General Surgery, Beijing Friendship Hospital, Capital Medical University, National Clinical Research Center of Digestive Diseases, Beijing 100050, People’s Republic of China. [*2]Department of Pharmacy, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200127, People’s Republic of China.
推荐引用方式(GB/T 7714)：
Wei Qi,Wei Zheng-Qiang,Jing Chang-Qing,et al.Incidence, prevention, risk factors, and prediction of venous thromboembolism in chinese patients after colorectal cancer surgery: a prospective, multicenter cohort study[J].INTERNATIONAL JOURNAL OF SURGERY.2023,109(10):3003-3012.doi:10.1097/JS9.0000000000000553.
APA：
Wei Qi,Wei Zheng-Qiang,Jing Chang-Qing,Li Yong-Xiang,Zhou Dong-Bing...&Zhang Zhong-Tao.(2023).Incidence, prevention, risk factors, and prediction of venous thromboembolism in chinese patients after colorectal cancer surgery: a prospective, multicenter cohort study.INTERNATIONAL JOURNAL OF SURGERY,109,(10)
MLA：
Wei Qi,et al."Incidence, prevention, risk factors, and prediction of venous thromboembolism in chinese patients after colorectal cancer surgery: a prospective, multicenter cohort study".INTERNATIONAL JOURNAL OF SURGERY 109..10(2023):3003-3012

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