Analysis Of Influencing Factors Of Venous Thromboembolism In Lung Cancer Patients Based On Caprini Score

Background and Objective:With the increasing incidence rate of lung cancer,the ranking remains high in malignant tumors.Venous Thromboembolism（VTE）is one of the common complications of malignant tumors and the second leading cause of death in cancer patients.The Caprini Risk Assessment Model is a more comprehensive assessment model for venous thromboembolism and is one of the most commonly used in clinical work at present.The purpose of this article is to analyse the influencing factors of venous thromboembolism in lung cancer patients at different Caprini score levels.Aimed at the different influencing factors of venous thrombosis in patients with lung cancer under different Caprini scores,we can take preventive measures in advance to reduce the occurrence of venous thromboembolism.Methods:The clinical data of 221 patients with lung cancer from January 2020 to September 2022 were enrolled.According to Caprini Risk Assessment Model,the lung cancer patients were scored and graded,the lung cancer patients combined with venous thromboembolism were set as the VTE group（n=69 cases）and the lung cancer patients without venous thromboembolism were set as the control group（n=152cases）.Through Caprini Risk Assessment Model scoring and grading,it is divided into two grades: Caprini score is high-risk and Caprini score is extremely high-risk.There were 21 cases in the VTE group and 90 cases in the control group with high-risk of Caprini score.There were 48 cases in the VTE group and 62 cases in the control group with extremely high-risk of Caprini score.The clinical data of lung cancer patients with high-risk of Caprini score and extremely high-risk of Caprini score were analyzed by SPSS21.0 software.In the measurement data,the data conforming to the normal distribution were represented by mean ± standard deviation（（?）±s）,and the comparison is performed by independent sample t-test;The data with non-normal distribution were represented by quartiles [P₅₀(P₂₅,P₇₅)],and the comparison was performed by rank-sum test.The counting data were represented by rate（%）,the comparison was performed by the chi-square test.Logistic regression analysis was used for multi-factor analysis,the Youden index was calculated by ROC curve to find the corresponding optimal threshold,and the meaningful indicators for single factor analysis were grouped by the optimal threshold.The test level was α = 0.05,and P<0.05 was considered statistically significant.Results:1、During the observation period,the incidence rate of venous thromboembolism in lung cancer patients with extremely high-risk of Caprini score（43.64%）was higher than that in lung cancer patients with high-risk of Caprini score（18.92%）,P < 0.001,the difference was considered statistically significant.2、By comparing the VTE groups of lung cancer patients with high-risk of Caprini score and extremely high-risk of Caprini score,it was found that the differences were statistically significant in age,smoking,adenocarcinoma,EGFR wild-type,treatment including chemotherapy regimens and central venous catheterization（P < 0.05）.Among them,the lung cancer patients with high-risk of Caprini score were younger [（59.90±7.27）years old] and the proportion of adenocarcinoma was higher（80.9%）;the lung cancer patients with extremely high-risk of Caprini score were older [（65.71±9.57）years old],and the proportion of adenocarcinoma and non-adenocarcinoma were the same as 50.0%.Lung cancer patients with extremely high-risk of Caprini score had a high proportion of smoking,epidermal growth factor receptor（EGFR）wild-type,treatment including chemotherapy regimens and central venous catheterization,accounting for 56.3%,77.1%,75.0% and 70.8% respectively;lung cancer patients with high-risk of Caprini score had a low proportion of smoking,EGFR wild-type,treatment including chemotherapy regimens and central venous catheterization,accounting for 28.6%,52.4%,47.6% and 0% respectively.3、The incidence rate of venous thromboembolism was the highest within one year after the diagnosis of cancer in lung cancer patients with high-risk of Caprini score,accounting for 38.1%;the incidence rate of lung cancer patients was the highest within 6 months with extremely high-risk of Caprini score,accounting for 47.9%.4、During the observation period,venous thromboembolism was most common in the lower extremities of lung cancer patients with high-risk of Caprini score,accounting for 71.4%;venous thromboembolism of lower extremities and cervical region veins was more common in lung cancer patients with extremely high-risk of Caprini score,39.5% and 41.7% respectively.5、According to the results of univariate analysis of lung cancer patients with high-risk of Caprini score,these were not statistically significant between the VTE group and the control group in sex,age,body mass index（BMI）,pathological type,tumor stage,EGFR mutation,smoking,treatment plan,antiangiogenic drugs,basic disease,leukocyte-elevating drugs,and preventive anticoagulation therapy（P >0.05）.In hematology indices,these were statistically significant between the VTE group and the control group in the levels of neutrophil/lymphocyte ratio（NLR）,NLR/D-dimer,hemoglobin,prothrombin time（PT）,D-dimer and albumin（P < 0.05）.6、The results of logistic regression analysis showed that NLR and PT were the independent risk factors for venous thromboembolism in lung cancer patients with high-risk of Caprini score.7、According to the results of univariate analysis of lung cancer patients with extremely high-risk of Caprini score,these were not statistically significant between the VTE group and the control group in sex,age,BMI,pathological type,tumor stage,EGFR mutation,smoking,treatment plan,antiangiogenic drugs,basic disease,leukocyte-elevating drugs,and preventive anticoagulation therapy,central venous catheterization（P > 0.05）.In hematology indices,these was statistically significant between the VTE group and the control group in the levels of D-dimer,the VTE group was higher than that the control group（P <0.05）.Conclusion:1、Lung cancer patients with high-risk of Caprini score were younger and had a higher proportion of adenocarcinoma;lung cancer patients with extremely high-risk of Caprini score were older and had a higher proportion of smoking,EGFR wild-type,treatment including chemotherapy regimens,and central venous catheterization.Lung cancer patients with high-risk of Caprini score had the highest incidence rate of venous thromboembolism within one year after the diagnosis of cancer,and venous thromboembolism of the lower extremities was the most common;the incidence rate of venous thromboembolism is the highest in lung cancer patients with extremely high-risk of Caprini score within 6 months after diagnosis of cancer,and venous thromboembolism of lower extremities and cervical region veins was more common.2、NLR,NLR/D-dimer,hemoglobin,PT,D-dimer and albumin were the risk factors for venous thromboembolism in lung cancer patients with high-risk of Caprini score,and NLR and PT were the independent risk factors.3、D-dimer is a risk factor for venous thromboembolism in lung cancer patients with extremely high-risk of Caprini score.