COMPASS-CAT风险评估模型对结直肠癌患者静脉血栓栓塞症的风险预测价值

Risk prediction of venous thromboembolism in colorectal cancer patients based on COMPASS-CAT risk assessment model

目的探讨COMPASS-CAT风险评估模型以及新预测模型对结直肠癌患者静脉血栓栓塞症(venous thromboembolism,VTE)的风险预测价值。方法收集2019年9月至2021年6月在苏北人民医院肿瘤科住院治疗的结直肠癌患者,其中被确诊为VTE的71例患者作为VTE组,并选择同期入院的142例非VTE患者作为非VTE组。依据COMPASS-CAT评估模型对两组患者进行评分和危险度分级,比较两组患者的一般临床资料、评分情况等,采用Logistic回归模型分析影响VTE发生的危险因素,并尝试构建一种更为有效的预测模型用于临床。结果VTE组在血红蛋白≥100 g/L、肠梗阻病史、D-二聚体≥0.55 mg/L、COMPASS-CAT评分≥7分的比例均高于非VTE组,差异有统计学意义(P<0.05)。多因素分析显示:D-二聚体≥0.55 mg/L和COMPASS-CAT评分≥7分均是影响VTE发生的高风险因素(P<0.05)。在COMPASS-CAT预测模型基础上,纳入D-二聚体≥0.55 mg/L构建新的预测模型。COMPASS-CAT模型和新构建的COMPASS-CAT预测模型的AUC分别为0.70和0.78,差异有统计学意义(P=0.002)。结论本研究验证了COMPASS-CAT风险评估模型在结直肠癌患者中VTE风险评估的临床价值,COMPASS-CAT风险评估模型纳入D-二聚体≥0.55 mg/L可以构建出更加精准的血栓风险评估模型。

Objective To investigate the value of COMPASS-cancer associated thrombosis(COMPASS-CAT)risk assessment model and new prediction model in predicting the risk of venous thromboembolism(VTE)in patients with colorectal cancer.Methods 71 colorectal cancer patients hospitalized in the Department of Oncology,Subei People′s Hospital from Sep.2019 to Jun.2021,of which were diagnosed with VTE as the VTE group,and 142 non-VTE patients hospitalized in the same period were selected as the non-VTE group.According to COMPASS-CAT evaluation model,the patients of two groups were scored and risk graded,and the general clinical data and scores of the patients were compared.Logistic regression model was used to analyze the risk factors affecting the occurrence of VTE,and a more effective prediction model was tried to be constructed for clinical use.Results The proportion of hemoglobin≥100 g/L,intestinal obstruction history,D-dimer≥0.55 mg/L,COMPASS-CAT score≥7 in VTE group were higher than those in non-VTE group(P<0.05),the difference was statistically significant(P<0.05).Multivariate analysis showed that D-dimer≥0.55 mg/L and COMPASS-CAT score≥7 were high-risk factors affecting the occurrence of VTE(P<0.05).On the basis of COMPASS-CAT prediction model,a new prediction model was constructed by incorporating D-dimer≥0.55 mg/L.AUC of COMPASS-CAT model and the newly constructed COMPASS-CAT prediction model were 0.70 and 0.78,respectively.Compared with COMPASS-CAT model,the difference was statistically significant(P=0.002).Conclusion This study verifies the clinical value of COMPASS-CAT risk assessment model in VTE risk assessment in patients with colorectal cancer.The inclusion of D-dimer≥0.55 mg/L in COMPASS-CAT risk assessment model can build a more accurate thrombus risk assessment model.