Analysis of risk factors and establishment of prediction model for lower extremity deep vein thrombosis after lumbar fusion surgery

Abstract Background Lower extremity deep vein thrombosis (LEDVT) is a common complication after orthopedic surgery. Currently, a reliable assessment tool is lacking to evaluate the risk of postoperative LEDVT in patients undergoing lumbar fusion surgery. This study aims to explore the risk factors f...

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Main Authors: Yixiang Zhao, Xiangzhen Kong, Kangle Song, Zhenchuan Liu, Yuanqiang Zhang, Lei Cheng
Format: Article
Language:English
Published: BMC 2024-12-01
Series:BMC Surgery
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Online Access:https://doi.org/10.1186/s12893-024-02689-5
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author Yixiang Zhao
Xiangzhen Kong
Kangle Song
Zhenchuan Liu
Yuanqiang Zhang
Lei Cheng
author_facet Yixiang Zhao
Xiangzhen Kong
Kangle Song
Zhenchuan Liu
Yuanqiang Zhang
Lei Cheng
author_sort Yixiang Zhao
collection DOAJ
description Abstract Background Lower extremity deep vein thrombosis (LEDVT) is a common complication after orthopedic surgery. Currently, a reliable assessment tool is lacking to evaluate the risk of postoperative LEDVT in patients undergoing lumbar fusion surgery. This study aims to explore the risk factors for LEDVT formation after lumbar fusion surgery and establish a predictive model for it. Methods Data of patients admitted for multi-center spinal surgery from May 2022 to September 2023 were retrospectively collected. Patients were divided into DVT and non-DVT groups based on the occurrence of LEDVT after surgery. Potential risk factors were initially identified through intergroup comparative analysis and single-factor logistic regression, which were considered candidate indicators. LASSO regression was applied to select candidate indicators, and the filtered variables were included in a multivariable logistic regression model. Nomogram and dynamic nomogram were constructed to visualize the model, and the model was subsequently validated. Results Factors including weakened lower extremity muscle strength, intraoperative blood loss, walking impairment, and Venous reflux/ Varicose veins were included in the multivariable logistic regression model. The results showed that the model had an area under the receiver operating characteristic curve of 0.870, 0.777 and 0.750 for the training set, internal validation set, and external validation set, respectively. Nomograms and web-based dynamic nomograms were created based on the multivariable logistic regression model. The model exhibited good performance in calibration curves and decision analysis. Conclusion The study identified weakened lower extremity muscle strength, intraoperative blood loss, walking impairment, and Venous reflux/ Varicose veins as risk factors for LEDVT formation following lumbar fusion surgery. The predictive tool established based on the logistic regression model demonstrated good performance and can be considered for assessing the risk of LEDVT formation after lumbar fusion surgery.
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spelling doaj-art-ab9b61e263844ccd88ff83f40e362e8f2025-08-20T02:39:51ZengBMCBMC Surgery1471-24822024-12-0124111110.1186/s12893-024-02689-5Analysis of risk factors and establishment of prediction model for lower extremity deep vein thrombosis after lumbar fusion surgeryYixiang Zhao0Xiangzhen Kong1Kangle Song2Zhenchuan Liu3Yuanqiang Zhang4Lei Cheng5Department of Orthopedics, Qilu Hospital of Shandong UniversityDepartment of Orthopedics, Qilu Hospital of Shandong UniversityDepartment of Orthopedics, Qilu Hospital of Shandong UniversityDepartment of Orthopedics, Qilu Hospital of Shandong UniversityDepartment of Orthopedics, Qilu Hospital of Shandong UniversityDepartment of Orthopedics, Qilu Hospital of Shandong UniversityAbstract Background Lower extremity deep vein thrombosis (LEDVT) is a common complication after orthopedic surgery. Currently, a reliable assessment tool is lacking to evaluate the risk of postoperative LEDVT in patients undergoing lumbar fusion surgery. This study aims to explore the risk factors for LEDVT formation after lumbar fusion surgery and establish a predictive model for it. Methods Data of patients admitted for multi-center spinal surgery from May 2022 to September 2023 were retrospectively collected. Patients were divided into DVT and non-DVT groups based on the occurrence of LEDVT after surgery. Potential risk factors were initially identified through intergroup comparative analysis and single-factor logistic regression, which were considered candidate indicators. LASSO regression was applied to select candidate indicators, and the filtered variables were included in a multivariable logistic regression model. Nomogram and dynamic nomogram were constructed to visualize the model, and the model was subsequently validated. Results Factors including weakened lower extremity muscle strength, intraoperative blood loss, walking impairment, and Venous reflux/ Varicose veins were included in the multivariable logistic regression model. The results showed that the model had an area under the receiver operating characteristic curve of 0.870, 0.777 and 0.750 for the training set, internal validation set, and external validation set, respectively. Nomograms and web-based dynamic nomograms were created based on the multivariable logistic regression model. The model exhibited good performance in calibration curves and decision analysis. Conclusion The study identified weakened lower extremity muscle strength, intraoperative blood loss, walking impairment, and Venous reflux/ Varicose veins as risk factors for LEDVT formation following lumbar fusion surgery. The predictive tool established based on the logistic regression model demonstrated good performance and can be considered for assessing the risk of LEDVT formation after lumbar fusion surgery.https://doi.org/10.1186/s12893-024-02689-5Lower extremity deep vein thrombosisLumbar fusion surgeryPredict model
spellingShingle Yixiang Zhao
Xiangzhen Kong
Kangle Song
Zhenchuan Liu
Yuanqiang Zhang
Lei Cheng
Analysis of risk factors and establishment of prediction model for lower extremity deep vein thrombosis after lumbar fusion surgery
BMC Surgery
Lower extremity deep vein thrombosis
Lumbar fusion surgery
Predict model
title Analysis of risk factors and establishment of prediction model for lower extremity deep vein thrombosis after lumbar fusion surgery
title_full Analysis of risk factors and establishment of prediction model for lower extremity deep vein thrombosis after lumbar fusion surgery
title_fullStr Analysis of risk factors and establishment of prediction model for lower extremity deep vein thrombosis after lumbar fusion surgery
title_full_unstemmed Analysis of risk factors and establishment of prediction model for lower extremity deep vein thrombosis after lumbar fusion surgery
title_short Analysis of risk factors and establishment of prediction model for lower extremity deep vein thrombosis after lumbar fusion surgery
title_sort analysis of risk factors and establishment of prediction model for lower extremity deep vein thrombosis after lumbar fusion surgery
topic Lower extremity deep vein thrombosis
Lumbar fusion surgery
Predict model
url https://doi.org/10.1186/s12893-024-02689-5
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