Risk factors for venous thromboembolism and evaluation of the modified Caprini score in patients undergoing lung resection

BACKGROUND: There is a high incidence of venous thromboembolism (VTE) after lung resection, so it is necessary to identify the risk factors for VTE in these patients. It is also important to evaluate whether the modified Caprini score can accurately assess the risk of VTE in patients after lung resection. METHODS: This retrospective study included 437 patients undergoing lung resection between July 2016 and December 2017. All patients underwent lower extremities ultrasound before and after operation to determine the presence of the newly diagnosed VTE. RESULTS: Forty-seven (10.8%) of the 437 patients were diagnosed with VTE after lung surgery. Multivariate logistic regression analysis showed that age (OR, 2.04; 95% CI, 1.40–2.99), duration of operation (OR, 1.51; 95% CI, 1.08–2.12), lymphocyte count (OR, 0.28; 95% CI, 0.11–0.69), and D-dimer concentration (OR, 1.55; 95% CI, 1.22–1.97) were significantly associated with VTE in lung resection patients. The cut-off values for lymphocyte count and D-dimer concentration determined using receiver operating characteristic (ROC) curve were 1.15×10(9)/L and 1.37 µg/mL respectively. The modified Caprini score divided the patients into three groups: low risk (0–4 points), moderate risk (5–8 points) and high risk (≥9 points), and the incidence of VTE was 12.3% (37/300), 7.5% (10/133) and 0% (0/4), respectively (P>0.05). CONCLUSIONS: In this study, we identified four independent factors for VTE after lung resection patients: age, duration of operation, lymphocyte count, and D-dimer. According to the modified Caprini score, there were fewer patients in the high-risk group, and the incidence of VTE not increased with the increase of risk. Better evaluation of operation time and D-dimer may help the modified Caprini score to better assess VTE risk in these patients.