Analysis of Influencing Factors and Development of a Nomogram Prediction Model for Postoperative Pulmonary Embolism Following Thoracoscopic Radical Resection in NSCLC Patients
LI Haimeng
JIA Jinrui
WANG Wenjiao
LIU Yi
YE Xin
Abstract：Objective To investigate the influencing factors of pulmonary embolism(PE)after thoracoscopic radical resection in patients with non-small cell lung cancer(NSCLC)and to construct a nomogram prediction model,in order to provide more reference for clinical prevention and treatment.Methods The clinical data of 208 NSCLC patients who underwent thoracoscopic radical resection at Beijing Chaoyang Hospital Affiliated to Capital Medical University from May 2023 to March 2025 were retrospectively selected.Based on the occurrence of pulmonary embolism within 30 days after surgery,patients were divided into a PE group(23 cases)and a non-PE group(185 cases).Collected clinical data included basic patient information,comorbidities,disease characteristics,preoperative laboratory parameters(white blood cell count,platelet count,albumin,fibrinogen,D-dimer,activated partial thromboplastin time),preoperative pulmonary function indicators[forced expiratory volume in 1 second(FEV1),forced vital capacity],surgery-related parameters[surgical approach(uniportal thoracoscopy,multiportal thoracoscopy),operation time,intraoperative blood loss,number of lymph nodes dissected,blood transfusion],and postoperative recovery outcomes.Differences in the above data between the two groups were compared.Multivariate logistic regression analysis was used to identify independent risk factors for PE after thoracoscopic radical resection in NSCLC patients.Based on the regression results,a nomogram prediction model was constructed,and a receiver operating characteristic(ROC)curve was plotted to validate the predictive value of the model.Results The proportions of patients with smoking history,COPD,and adenocarcinoma in the PE group were higher than those in the non-PE group(P<0.05).Preoperative platelet count,fibrinogen,D-dimer,and postoperative D-dimer were higher than those in the non-PE group(P<0.05),while albumin,FEV1,and postoperative urine output were lower than those in the non-PE group(P<0.05).Multivariate logistic regression analysis showed that COPD(OR=7.478,95%CI:3.126-17.889),pathological type adenocarcinoma(OR=4.627,95%CI:2.064-10.376),high preoperative fibrinogen level(OR=6.309,95%CI:3.259-12.213),low postoperative urine output(OR=0.289,95%CI:0.112-0.748),and high postoperative D-dimer level(OR=7.043,95%CI:3.681-13.474)were independent risk factors for PE after thoracoscopic radical resection in NSCLC patients(P<0.05).The ROC curve showed that the area under the curve of the nomogram prediction model for PE after thoracoscopic radical resection in NSCLC patients was 0.935(95%CI:0.893-0.965),with a sensitivity and specificity of 82.61%and 99.46%,respectively.Conclusions COPD,adenocarcinoma,high preoperative fibrinogen level,low postoperative urine output,and high postoperative D-dimer level are independent risk factors for PE after thoracoscopic radical resection in NSCLC patients.The nomogram constructed based on the above factors has high predictive performance and can serve as an effective tool for clinicians to predict PE after thoracoscopic radical resection in NSCLC patients.
Keywords：non-small cell lung cancerthoracoscopic radical resectionpulmonary embolismrisk factorsnomogram
Publication Date：2026-01-20
Online Publishing Date：2026-01-24(First online date of this platform, not the publication date of the document)
Pages：6( 72-77 )