Nomogram for Predicting Postoperative Portal Venous Systemic Thrombosis in Patients with Cirrhosis Undergoing Splenectomy and Esophagogastric Devascularization.
Can J Gastroenterol Hepatol
; 2022: 8084431, 2022.
Article
em En
| MEDLINE
| ID: mdl-36387035
ABSTRACT
Objectives:
The aim of the study is to develop a nomogram for predicting postoperative portal venous systemic thrombosis (PVST) in patients with cirrhosis undergoing splenectomy and esophagogastric devascularization.Methods:
In total, 195 eligible patients were included. Demographic characteristics were collected, and the results of perioperative routine laboratory investigations and ultrasound examinations were also recorded. Blood cell morphological traits, including the red cell volume distribution width (RDW), mean platelet volume, and platelet distribution width, were identified. Univariate and multivariate logistic regressions were implemented for risk factor filtration, and an integrated nomogram was generated and then validated using the bootstrap method.Results:
A color Doppler abdominal ultrasound examination on a postoperative day (POD) 7 (38.97%) revealed that 76 patients had PVST. The results of the multivariate logistic regression suggested that a higher RDW on POD3 (RDW3) (odds ratio (OR) 1.188, 95% confidence interval (CI) 1.073-1.326), wider portal vein diameter (OR 1.387, 95% CI 1.203-1.642), history of variceal hemorrhage (OR 3.407, 95% CI 1.670-7.220), and longer spleen length (OR 1.015, 95% CI 1.001-1.029) were independent risk parameters for postoperative PVST. Moreover, the nomogram integrating these four parameters exhibited considerable capability in PVST forecasting. The nomogram's receiver operating characteristic curve reached 0.83 and achieved a sensitivity and specificity of 0.711 and 0.848, respectively, at its cutoff. The nomogram's calibration curve demonstrated that it was well calibrated.Conclusion:
The nomogram exhibited excellent performance in PVST prediction and might assist surgeons in identifying vulnerable patients and administering timely prophylaxis.
Texto completo:
1
Bases de dados:
MEDLINE
Assunto principal:
Varizes Esofágicas e Gástricas
/
Trombose Venosa
/
Hipertensão Portal
Tipo de estudo:
Etiology_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Humans
Idioma:
En
Revista:
Can J Gastroenterol Hepatol
Ano de publicação:
2022
Tipo de documento:
Article
País de afiliação:
China