Case Control Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Aug 6, 2024; 12(22): 4881-4889
Published online Aug 6, 2024. doi: 10.12998/wjcc.v12.i22.4881
Establishment of a nomogram model for predicting therapy complications in patients with polycythemia and deep venous thrombosis
Ming-Xian Zhao, Guo-Jie Li
Ming-Xian Zhao, Guo-Jie Li, Department of Vascular Surgery, Qinghai Province Cardiovascular and Cerebrovascular Disease Specialist Hospital, Xining 810000, Qinghai Province, China
Author contributions: Zhao MX performed the majority of the experiments and wrote the manuscript, and Li GJ was responsible for data collection and statistical processing.
Supported by Guiding Project of Qinghai Provincial Health Commission, No. 2021-wjzdx-89.
Institutional review board statement: This study was approved by the Ethics Committee of Qinghai Province Cardiovascular and Cerebrovascular Disease Specialist Hospital.
Informed consent statement: All patients gave their informed consent.
Conflict-of-interest statement: No benefits in any form have been received or will be received from any commercial party directly or indirectly related to the subject of this article.
Data sharing statement: The technical appendix, statistical code, and dataset are available upon reasonable request from the corresponding author.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Guo-Jie Li, MBChB, Associate Chief Physician, Department of Vascular Surgery, Qinghai Province Cardiovascular and Cerebrovascular Disease Specialist Hospital, No. 7 Zhuanchang Road, Chengzhong District, Xining 810000, Qinghai Province, China. liguojieli@126.com
Received: May 10, 2024
Revised: June 13, 2024
Accepted: June 17, 2024
Published online: August 6, 2024
Processing time: 52 Days and 20 Hours
Abstract
BACKGROUND

Patients with deep venous thrombosis (DVT) residing at high altitudes can only rely on anticoagulation therapy, missing the optimal window for surgery or thrombolysis. Concurrently, under these conditions, patient outcomes can be easily complicated by high-altitude polycythemia (HAPC), which increases the difficulty of treatment and the risk of recurrent thrombosis. To prevent reaching this point, effective screening and targeted interventions are crucial. Thus, this study analyzes and provides a reference for the clinical prediction of thrombosis recurrence in patients with lower-extremity DVT combined with HAPC.

AIM

To apply the nomogram model in the evaluation of complications in patients with HAPC and DVT who underwent anticoagulation therapy.

METHODS

A total of 123 patients with HAPC complicated by lower-extremity DVT were followed up for 6-12 months and divided into recurrence and non-recurrence groups according to whether they experienced recurrence of lower-extremity DVT. Clinical data and laboratory indices were compared between the groups to determine the influencing factors of thrombosis recurrence in patients with lower-extremity DVT and HAPC. This study aimed to establish and verify the value of a nomogram model for predicting the risk of thrombus recurrence.

RESULTS

Logistic regression analysis showed that age, immobilization during follow-up, medication compliance, compliance with wearing elastic stockings, and peripheral blood D-dimer and fibrin degradation product levels were indepen-dent risk factors for thrombosis recurrence in patients with HAPC complicated by DVT. A Hosmer-Lemeshow goodness-of-fit test demonstrated that the nomogram model established based on the results of multivariate logistic regression analysis was effective in predicting the risk of thrombosis recurrence in patients with lower-extremity DVT complicated by HAPC (χ2 = 0.873; P > 0.05). The consistency index of the model was 0.802 (95%CI: 0.799-0.997), indicating its good accuracy and discrimination.

CONCLUSION

The column chart model for the personalized prediction of thrombotic recurrence risk has good application value in predicting thrombotic recurrence in patients with lower-limb DVT combined with HAPC after discharge.

Keywords: Anticoagulation therapy, Deep vein thrombosis of the lower extremities, High-altitude polycythemia, Logistic regression analysis, Nomogram model, Thrombosis recurrence

Core Tip: This study found that age, immobilization during follow-up, medication compliance, compliance with wearing elastic stockings, and peripheral blood D-dimer and fibrin degradation product levels are independent risk factors for thrombosis recurrence in patients with lower-extremity deep venous thrombosis (DVT) and high-altitude polycythemia (HAPC). Furthermore, the nomogram model constructed using these factors demonstrated promising applications in predicting thrombosis recurrence after discharge, thereby providing a reference for predicting thrombosis recurrence in patients with lower-limb DVT combined with HAPC in clinical practice.