Key result
New 3-item nomogram outperforms Caprini score for predicting VTE after colorectal surgery, achieving AUC ~0.84.
Why the study?
This study aimed to assess the predictive value of the Caprini score for VTE events and develop a risk assessment model to predict short-term VTE after colorectal cancer surgery.
Does a new 3-item nomogram model improve the prediction of short-term VTE compared to the Caprini score in patients undergoing colorectal cancer surgery?
Cohort (n=181)
No
Does a new 3-item nomogram model improve the prediction of short-term VTE compared to the Caprini score in patients undergoing colorectal cancer surgery?
Absolute Event Rate: 0.837% vs 0.76%
A new 3-item nomogram model incorporating age, sex, and cardiovascular disease provides better predictive performance for short-term VTE after colorectal cancer surgery than the standard Caprini score.
Caprini score may aid short-term VTE prediction after colorectal cancer surgery; leaves open need for external validation before clinical adoption.
Background: This study aimed to assess the Caprini score in predicting venous thromboembolism (VTE) events and develop a risk assessment model to predict the occurrence of short-term VTE after colorectal cancer surgery. Methods: The study included 181 patients who underwent colorectal cancer surgery at Beijing Friendship Hospital, from October 2020 to May 2022. The results of the Caprini score 24 h after surgery were recorded to evaluate its predictive value. Multifactorial staging was used to determine independent risk factors for VTE, and nomogram models were constructed based on these factors. Sixty-one patients at Beijing Chaoyang Hospital were used for external validation. Results: The incidence of VTE after colorectal cancer was 17.6% in 32 patients. Age (odds ratio [OR] 1.106, 95% confidence interval [CI] 1.049–1.167, P < 0.001), sex (female) (OR 2.981, 95% CI 1.176–7.557, P = 0.021), and cardiovascular disease [CVD] (OR 5.611, 95% CI 2.043–15.413, P = 0.001) were independent risk factors for postoperative VTE. The nomogram model showed good predictive performance (area under the curve [AUC], 0.837 [95% CI, 0.762–0.917]; Nagelkerke R2, 0.347; Brier score, 0.106) compared with the Caprini score (AUC, 0.760 [95% CI, 0.674–0.847]; Nagelkerke R2, 0.104; Brier score, 0.131). The decision curve analysis showed that the nomogram model had a better net clinical benefit. Conclusions: The Caprini score is moderately efficient in predicting the occurrence of VTE after colorectal cancer surgery, and the 3-item nomogram model can be used as a predictive tool in VTE prevention decisions after colorectal cancer surgery.
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Wei et al. (2023) conducted a cohort in Colorectal Cancer (n=181). 3-item nomogram model (age, sex, cardiovascular disease) vs. Caprini score was evaluated on Prediction of postoperative venous thromboembolism (AUC) (95% CI 0.762-0.917). A new 3-item nomogram model demonstrated better predictive performance for postoperative venous thromboembolism (AUC 0.837) compared to the Caprini score (AUC 0.760) in patients undergoing colorectal cancer surgery.
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