结直肠癌患者围手术期VTE 风险评分动态变化的回顾性研究：基于 Caprini 量表的时序分析及护理启示（Retrospective Study on the Dynamic Changes in Perioperative VTE Risk Scores in Colorectal Cancer Patients: Temporal Analysis Based on the Caprini Scale and Nursing Implications）

Abstract：Objective To explore the dynamic evolution patterns of venous thromboembolism (VTE) risk in colorectal cancer patients during the perioperative period, analyze the risk changes at three time points (preoperative, 24 hours postoperative, and 72hours postoperative) based on the Caprini risk assessment scale, and provide evidence-based support for clinical implementation of dynamic VTE prevention. Methods A retrospective cohort study design was employed, selecting 180 colorectal cancer patients undergoing elective surgery at our hospital from June 2024 to June 2025 as the study subjects. General demographic data, disease-related information, and surgical details were collected. Caprini scores and risk levels were extracted at three time points: preoperative (T0),24 hours postoperative (T1), and 72 hours postoperative (T2). Statistical analyses were performed using repeated-measures ANOVA,Cochran’s Q test, and multiple linear regression. Results The Caprini scores among the 180 patients showed statistically significant differences across T0, T1, and T2 (F=287.34, P<0.001). Pairwise comparisons revealed that T1 scores were significantly higher than T0 and T2, while T2 scores were also significantly higher than T0 (all P<0.001). The distribution of risk levels changed significantly over time (χ²=213.56, P<0.001), with high-risk proportions at T0, T1, and T2 being 38.33%, 94.44%, and 91.67%, respectively.Multiple linear regression analysis identified age (β=0.032, P=0.012), operative duration (β=0.008, P<0.001), intraoperative blood loss (β=0.005, P=0.003), and tumor TNM stage (β=0.412, P=0.007) as independent factors influencing postoperative increases in Caprini scores. The symptomatic VTE incidence rate in this cohort was 0%, with mechanical prophylaxis implementation at 62.22%and pharmacological prophylaxis at 18.33%. Conclusion The perioperative VTE risk in colorectal cancer patients exhibits a dynamic upward trend, peaking at 24 hours postoperative. Older age, prolonged surgery, significant blood loss, and advanced tumor stage are associated with more pronounced risk increases. Clinically, a dynamic perioperative assessment mechanism should be established,with a focus on the critical 24-hour postoperative window period, and stratified precision interventions should be implemented for high-risk populations to enhance the effectiveness of VTE prevention and control.