Key result
A simplified 5-point risk assessment model predicted 60-day postoperative VTE incidence in thoracic surgery patients with 56% sensitivity and 77% specificity.
Why the study?
The Caprini model is burdensome, prompting the goal to simplify it for thoracic surgical patients undergoing lung cancer resection to better guide anticoagulation decision-making.
Can a simplified risk assessment model accurately predict 60-day postoperative VTE incidence in patients undergoing resection for lung cancer?
Cohort
No
Can a simplified risk assessment model accurately predict 60-day postoperative VTE incidence in patients undergoing resection for lung cancer?
p-value: p== .29
A simplified 5-point risk assessment model can identify high-risk thoracic surgery patients for extended postoperative VTE prophylaxis with 56% sensitivity and 77% specificity.
May aid targeted VTE prophylaxis in thoracic surgery; leaves open prospective validation before practice change.
Background: The risk of venous thromboembolism (VTE) in patients undergoing resection in the setting of lung cancer represents a major challenge to improving postoperative outcomes. The Caprini risk assessment model has been validated in general surgery to determine a role for extended chemoprophylaxis to reduce VTE events. Our goal was to simplify this burdensome model for the unique needs of this thoracic surgical population to better guide anticoagulation decision-making. Methods: Patients who underwent a resection for lung malignant neoplasm at our institution between June 2005 and June 2013 with available 60-day postoperative follow-up data were evaluated. Exclusion criteria were long-term anticoagulation, inferior vena cava filter, missing data, and loss to follow-up. Twelve selected risk factors were analyzed for each patient by logistic regression with stepwise inclusion to model 60-day VTE incidence. Results: = .29). Weighting of sex, age, history of VTE, surgical approach, and duration of procedure provides a low-risk or high-risk composite score with 56% sensitivity and 77% specificity. Conclusions: In this effort to model VTE incidence on the basis of a limited set of clinical risk factors, we demonstrated efficacy of retrospectively scoring patients with just 5 data points in anticipating risk of postoperative VTE. These high-risk surgical patients can be readily identified in the preoperative period to benefit from extended postoperative prophylaxis.
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Hui et al. (2022) conducted a cohort in Lung malignant neoplasm. 5-point VTE risk assessment model was evaluated on 60-day VTE incidence (p== .29). A simplified 5-point risk assessment model predicted 60-day postoperative VTE incidence in thoracic surgery patients with 56% sensitivity and 77% specificity.
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