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LI Xue, LI Shihong, YAO Yan, YUAN Jingjing. Establishment of a predictive model for postoperative bleeding risk in elderly patients receiving long-term anticoagulants after radical gastrectomy[J]. Journal of Xuzhou Medical University, 2022, 42(1): 67-71. DOI: 10.3969/j.issn.2096-3882.2022.01.014
Citation: LI Xue, LI Shihong, YAO Yan, YUAN Jingjing. Establishment of a predictive model for postoperative bleeding risk in elderly patients receiving long-term anticoagulants after radical gastrectomy[J]. Journal of Xuzhou Medical University, 2022, 42(1): 67-71. DOI: 10.3969/j.issn.2096-3882.2022.01.014

Establishment of a predictive model for postoperative bleeding risk in elderly patients receiving long-term anticoagulants after radical gastrectomy

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  • Received Date: August 05, 2020
  • Revised Date: October 24, 2021
  • Objective To establish a risk predictive model for postoperative bleeding risks in elderly gastric cancer patients receiving long-term anticoagulants after gastrectomy, and to provide reference for nursing care work. Methods A total of 30 gastric cancer patients with bleeding after gastrectomy (an observation group) and 200 elderly gastric cancer patients with little or without bleeding after gastrectomy (a control group) were analyzed, and their clinical data were retrospectively analyzed. The risk factors of postoperative bleeding were screened out by Logistic regression analysis to establish a predictive model for bleeding risks. A receiver operating characteristic (ROC) curve was used to evaluate the predictive performance of the risk predictive model. Both groups were compared for their postoperative clinical manifestation. Results Multivariate analysis showed that platelets<100×109/L, TNM stage Ⅲ and abdominal infection were independent risk factors for postoperative bleeding in elderly patients receiving long-term anticoagulants after gastrectomy. The AUC of the established predictive model was 0.736 (95% CI: 0.674—0.791), with a sensitivity of 60.00% and a specificity of 79.00%. The incidence of hematemesis, black stool and abnormal drainage fluid in the observation group was significantly higher than that in the control group (P<0.05). Conclusions Low platelet level, advanced patients and postoperative abdominal infection were the independent risk factors of postoperative bleeding in elderly patients receiving long-term anticoagulants after gastrectomy. It is necessary for medical nurses to be alert for the occurrence of postoperative bleeding according to clinical feature.
  • [1]
    Ferlay J,Colombet M,Soerjomataram I,et al.Estimating the global cancer incidence and mortality in 2018:GLOBOCAN sources and methods[J].Int J Cancer,2019,144(8):1941-1953.
    [2]
    郑静娴,王晓杰,余家密,等.血常规及乳酸脱氢酶与胃癌根治术后患者预后的相关性研究[J].徐州医科大学学报,2020,40(12):887-892.
    [3]
    康文哲,李洋,田艳涛.胃癌术后出血的诊断与治疗[J].国际外科学杂志,2017,44(10):649-651.
    [4]
    宗德宝,袁江涛,高登有,等.腹腔镜胃癌D2根治术后出血发生的危险因素分析[J].山西医药杂志,2018,47(16):7-10.
    [5]
    Yang J,Zhang XH,Huang YH,et al.Diagnosis and treatment of abdominal arterial bleeding after radical gastrectomy:a retrospective analysis of 1875 consecutive resections for gastric cancer[J].J Gastrointest Surg,2016,20(3):510-520.
    [6]
    姚雅极,邹圣强,胡佳民,等.老年肝衰竭患者预后影响因素分析及其预后模型的构建[J].江苏大学学报(医学版),2021,31(2):143-146,151.
    [7]
    Nelen SD,Bosscha K,Lemmens VEPP,et al.Morbidity and mortality according to age following gastrectomy for gastric cancer[J].Br J Surg,2018,105(9):1163-1170.
    [8]
    Linkins LA,Choi PT,Douketis JD.Clinical impact of bleeding in patients taking oral anticoagulant therapy for venous thromboembolism:a meta-analysis[J].Ann Intern Med,2003,139(11):893-900.
    [9]
    代晓强,马宁.腹腔镜下D2淋巴结清扫胃癌根治术后出血的危险因素分析[J].腹腔镜外科杂志,2019,24(6):410-413.
    [10]
    李业云,彭泉,张明金,等.腹腔镜胃癌根治术154例临床分析[J].中国微创外科杂志,2014,14(5):402-404.
    [11]
    吉国锋,张涛,马冲.腹腔镜与传统开腹手术治疗中国老年胃癌疗效对比的Meta分析[J].中国老年学杂志,2017,37(20):5092-5096.
    [12]
    Hu M,Trevino J,Yang L,et al.Primarygastric EBV-positive diffuse large B cell lymphoma (DLBCL) of the elderly with plasmablastic differentiation[J].In Vivo,2018,32(2):413-417.
    [13]
    张鹏,兰天珩,周一鸣,等.胃癌根治术围手术期并发症危险因素分析[J].中华胃肠外科杂志,2019,22(8):736-741.
    [14]
    张广坛,张学东,薛焕洲.进展期胃癌的手助腹腔镜全胃切除及D2淋巴结清扫[J].中华普通外科杂志,2015,30(10):762-765.

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