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<h5 class="section-title" id="d9761367e147">Background</h5>
<p id="d9761367e149">Venous thromboembolism (VTE) is an insidious disease with significant
morbidity and
mortality. We conducted a retrospective single-center study on patients who underwent
thoracic surgery and developed a novel VTE risk assessment model (RAM).
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<h5 class="section-title" id="d9761367e152">Methods</h5>
<p id="d9761367e154">Patients who underwent thoracic surgery between July 2016 and
December 2017 (n=533)
at the Beijing Chao-Yang Hospital were enrolled in this study. None of the patients
received any prophylaxis perioperatively. Lower limbs Doppler ultrasonography was
performed before and after surgery for deep venous thrombosis (DVT) confirmation.
Patients with new postoperative DVT, typical symptoms of pulmonary embolism (PE),
or high Caprini score (≥9) underwent further computer tomography pulmonary angiography
(CTPA) examination for PE. Caprini, Rogers, Padua, and Khorana RAM were used for all
of the patients. A novel RAM of VTE, which we called Chao-Yang VTE RAM, was developed
according to the logistic regression analysis.
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<h5 class="section-title" id="d9761367e157">Results</h5>
<p id="d9761367e159">The overall incidence of VTE after thoracic surgery was 8.4%
(45 of 533). Among the
45 VTE patients, 86.7% have DVT and 13.3% have DVT + PE. Age ≥60 (OR 4.51, 95% CI:
2.09–9.71, P=0.000) has an independent risk factor for VTE. The areas under the receiver
operating characteristic (ROC) curve of Caprini, Rogers, Padua, Khorana, and Chao-Yang
models were 0.74 (P<0.0001), 0.52 (P=0.62), 0.69 (P<0.0001), 0.64 (P=0.0017),
and
0.80 (P<0.0001), respectively. The VTE incidence in the low-, moderate-, and high-risk
groups predicted with Chao-Yang scores was 1.3% (3 of 230), 8.4% (14 of 166), and
20.4% (28 of 137); these were 1.6% (3 of 192), 11.9% (38 of 318), and 17.4% (4 of
23), respectively, when using the Caprini criteria. The high-risk group had a significantly
higher incidence than the low- and moderate-risk groups (P=0.000). Additionally, as
the number of risk factors increased, the incidence of VTE increased from 1.2% to
50.0%.
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<h5 class="section-title" id="d9761367e162">Conclusions</h5>
<p id="d9761367e164">The incidence of VTE in patients who underwent major thoracic
surgery was high in
our series. Based on a retrospective single-center population study, we developed
a novel prediction model to identify patients receiving thoracic surgery with different
risks for VTE events.
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