Development and application of evaluation criteria for venous thromboembolism prevention in patients with gynecologic malignancies during the perioperative period

Background Patients with gynecologic malignancies face a high perioperative VTE risk and suboptimal prevention adherence, yet lack systematic, evidence-based evaluation standards. Objective To develop and preliminarily validate evidence-based, comprehensive evaluation criteria for perioperative VTE prevention in this population. Methods The Delphi method was employed to formulate the evaluation criteria for VTE prevention in this population. The Attribute Hierarchical Model (AHM) was used to assign a weight to each indicator, and the Technique for Order Preference by Similarity to Ideal Solution (TOPSIS) was applied to evaluate adherence to perioperative VTE prevention standards among patients undergoing gynecologic surgery at our hospital. Results The final criteria included 12 indicators covering quantitative and dynamic VTE risk assessment, bleeding risk evaluation, implementation of basic prophylaxis, assessment of indications and contraindications for mechanical and pharmacologic prophylaxis, timing, dosing, and duration of anticoagulant prophylaxis, and monitoring of efficacy and safety. The indicator weight coefficients ranged from 0.0234 to 0.1357. Among the 107 patients, 62 (57.94%) had C i ≥ 0.6, and 45 (42.06%) had C i < 0.6. Indicator-level analysis showed 100% compliance for basic prophylaxis, mechanical prophylaxis indications, and absence of contraindications to pharmacologic prophylaxis. The lowest compliance rates were observed for quantitative VTE risk assessment (25.23%, 27/107), dynamic VTE risk assessment (32.71%, 35/107), initiation timing (24.30%, 26/107), prophylaxis duration (24.30%, 26/107), and efficacy and safety monitoring (14.95%, 16/107). Conclusion This study developed scientifically grounded and clinically feasible evaluation criteria for perioperative VTE prevention in patients with gynecologic malignancies. They provide a practical basis for quality improvement and ongoing refinement of institutional VTE prevention strategies.