Kelly et al report a model for predicting postoperative venous thromboembolism in a patient undergoing thoracolumbar spine surgery for a degenerative condition. This can help to identify a patient who may benefit from more aggressive thromboprophylaxis. The authors are from Anne Arundel Medical Center in Annapolis.
Patient selection: fusion for a degenerative condition of the thoracolumbar spine
Parameters from preoperative assessment:
(1) age in years
(2) body mass index (BMI)
(3) operative time in minutes
(4) sex
(5) smoker
(6) disseminated cancer
(7) bleeding disorder
(8) ASA status
(9) wound infection (open wound)
Parameter
Finding
Points
age in years
< 70 years
0
>= 70 years
0.364
BMI
< 35
0
>= 35
0.293
operative time
< 270 minutes
0
>= 270
0.822
sex
male
0
female
-0.191
smoker
no
0
yes
-0.354
disseminated cancer
no
0
yes
1.27
bleeding disorder
no
0
yes
0.455
ASA status
1 or 2
0
>= 3
0.222
wound infection
no
0
yes
1.188
value of X =
= SUM(points for all of the parameters) - 4.783
probability of venous thromboembolism =
= 1 / (1 + EXP((-1) * X))
Performance:
• The area under the ROC curve is 0.68.
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