CONUT score as a predictor of venous thromboembolism in high-risk hospitalized cancer patients based on Caprini risk assessment model.

Abstract

e24013 Background: Venous thromboembolism (VTE) is a major cause of morbidity and mortality in cancer patients. However, current predictive tools, such as the Caprini risk assessment model (Caprini RAM), have limitations. This research aimed to evaluate the predictive value of Controlling Nutritional Status (CONUT) score for VTE in high-risk hospitalized cancer patients based on CRA model, and create a novel predictive model for forecasting the risk of VTE in cancer patients. Methods: This single-center, retrospective study included 2081 high-risk hospitalized cancer patients identified using the Caprini RAM, treated between January 2018 and January 2024. Patients were divided into two groups: the VTE group (n=684) and the control group (n=1397), based on the occurrence of VTE within two years of cancer diagnosis. Risk factors for VTE were analyzed using binary logistic regression, and a clinical predictive model for VTE was developed and evaluated for accuracy. Results: A total of 2081 cancer patients with high risk of Caprini RAM score were included in this study. Patients were randomized into the training set and the test set in a 7:3 ratio. Regression analysis based on the training set showed that advanced age, ECOG 2, PORT/ PICC, antiangiogenic therapy, immunotherapy, lower limb fracture, varicose veins, advanced tumor stage, D-dimer> 500(mg/L FEU), and elevated CONUT score were the risk predictors the occurrence of VTE (p <0.005). In addition, a clinical model to predict VTE in Caprini RAM high-risk tumor patients was established based on influence factors, with high accuracy by test set. Conclusions: CONUT score is positively correlated with the occurrence of VTE in Caprini RAM high-risk cancer patients, and the established clinical model has high accuracy in predicting the occurrence of VTE in Caprini RAM high-risk cancer patients. Risk factors of VTE occurrence in Caprini RAM high-risk cancer patients. Parameter p value OR [95CI%] Male <0.001 0.675 [0.542, 0.841] Age <0.001 8.079 [4.991, 13.627] ECOG score <0.001 1.952 [1.561, 2.443] Tumor-bearing <0.001 2.157 [1.728, 2.696] PORT/PICC <0.001 9.805 [3.182, 42.685] Chemotherapy <0.001 2.371 [1.876, 2.998] Hormones Treatment 0.004 1.787 [1.204, 2.643] Anti-VEGFR Treatment <0.001 4.128 [2.982, 5.755] Immunotherapy <0.001 5.166 [3.981, 6.765] Chronic diseases 0.951 1.007 [0.799, 1.267] High-risk tumor 0.231 0.866 [0.685, 1.097] Fracture of lower limb <0.001 42.658 [8.855, 766.745] Varicose vein of lower limb 0.002 7.655 [2.377, 33.963] Stage <0.001 0.775 [0.705, 0.851] D-dimer (mg/L FEU) <0.001 8.961 [6.365, 12.960] Conut score <0.001 0.521 [0.485, 0.558] PORT port-cath, PICC peripherally Inserted Central Cathete, CONUT Controlling Nutritional Status.