Risk Assessment Of Venous Thromboembolism In Patients With Oromaxillofacial-head And Neck Cancer And Its Establishment Of The Diagnostic Prediction Model

Objective: To study the risk factors of venous thromboembolism(VTE)in patients with oral and maxillofacial-head and neck malignant tumors(OMHNC),and the establishment of nomogram is needed to predict the risk factors of VTE in patients with OMHNC.Method: From December 2018 to December 2021,55 patients with OMHNC complicated with VTE and 165 patients without OMHNC complicated with VTE were collected,and the data of demographic indicators,the situation of treatment in the hospital and blood biochemical results were included into univariate analysis.The Lasso algorithm and directed acyclic graph were used to optimize the selection of variables.Using multivariate Logistic regression to build a nomogram predictive model of OMHNC concurrent VTE cases,and it was verified by using(receiver operating characteristic)ROC and Bootstrap resampling1000 times.Results: VTE was more likely to occur in middle and late OMHNC(P= 0.026).The higher the surgical grade,the higher the risk of VTE(P = 0.001).Treatment history in intensive care unit will make VTE risk(P = 0.008).The blood routine index of fibrinogen degradation products,thrombin time,D-dimer,leukocyte neutrophil count,erythrocyte distribution width,C-reactive protein,globulin(GLB),(aspartate aminotransferase)AST in VTE group were higher than those in non-VTE group(P < 0.05).The blood routine index of red blood cell,hemoglobin,hematopoietic cell transplantation,mean corpuscular hemoglobin,albumin,Cholinesterase,glutamyl transpeptidase,osmotic pressure in VTE group was lower than that in non-VTE group(P < 0.05).The nomogram predictive model includes five indexes: history of surgery,history of radiotherapy and chemotherapy,D-D,AST,GLB.The C-statistic of ROC curve is 0.981;Bootstrap method repeated sampling 1000 times of C-index 0.972.Calibration and decision curve show that the nomogram predictive model has good prediction performance and clinical practical value.Conclusion: VTE was more likely to occur in middle and late OMHNC.The higher the surgical grade,the higher the risk of VTE.Treatment history in intensive care unit will make VTE risk.History of surgery,the history of radiotherapy and chemotherapy,D-D,AST,GLB increase are the risk factors of VTE in OMHNC patients.The nomogram predictive model based on the above factors can predict the risk and accuracy of VTE,so it can guide the prevention of VTE in OMHNC patients.