Venous thromboembolism (VTE) is a potentially life-threatening but preventable complication after urological surgery. Physicians are faced with the challenges of weighing the risks and benefits of thromboprophylaxis given scanty evidence for or against and practice variation worldwide. The primary objective of the study was to explore the possibility of a risk-stratified approach for thromboembolism prophylaxis following radical prostatectomy. A prospective database was accessed to cross-link venous thromboembolism events in 522 men who underwent minimally invasive prostatectomy between February 2010 and October 2021. A deterministic data linkage method was used to record events through electronic systems. Community Health Index (CHI) numbers were used to identify patients via electronic health records. Patient demographics and clinical characteristics such as age, comorbidities, Gleason staging, and readmission details accrued. VTE within 90 days and development of a risk-stratified scoring system. All statistical analysis was performed using R-Statistical Software and the risk of VTE within 90 days of surgery was estimated via gradient-boosting decision trees (BRT) model. 1.1% (6/522) of patients developed deep vein thrombosis or pulmonary embolism within 3 months post-minimally invasive prostatectomy. Statistical analysis demonstrated a significant difference in the body mass index (p = 0.016), duration of hospital stay (p < 0.001), and number of readmissions (p = 0.036) between patients who developed VTE versus patients who did not develop VTE. BRT analysis found 8 variables that demonstrated relative importance in predicting VTE. The receiver operating curves (ROC) were constructed to assess the discrimination power of a new model. The model showed an AUC of 0.97 (95% confidence intervals [CI]: 0.945,0.999). For predicting VTE, a single-center study is a limitation. The incidence of VTE post-minimally invasive prostatectomy in men who did not receive prophylaxis with low molecular weight heparin is low (1.1%). The proposed risk-scoring system may aid in the identification of higher-risk patients for thromboprophylaxis. In this report, we looked at the outcomes of venous thromboembolism following minimally invasive radical prostatectomy for prostate cancer in consecutive men. We developed a new scoring system using advanced statistical analysis. We conclude that the VTE risk is very low and our model, if applied, can risk stratify men for the development of VTE following radical surgery for prostate cancer.

中文翻译：

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增强回归模型在评估未接受药物预防的前列腺癌男性微创根治手术后静脉血栓栓塞风险的预测准确性

静脉血栓栓塞（VTE）是泌尿外科手术后可能危及生命但可以预防的并发症。鉴于支持或反对的证据很少，并且世界范围内的实践存在差异，医生面临着权衡血栓预防的风险和益处的挑战。该研究的主要目的是探讨采用风险分层方法预防根治性前列腺切除术后血栓栓塞的可能性。访问前瞻性数据库，对 2010 年 2 月至 2021 年 10 月期间接受微创前列腺切除术的 522 名男性的静脉血栓栓塞事件进行交叉链接。使用确定性数据链接方法通过电子系统记录事件。社区健康指数 (CHI) 编号用于通过电子健康记录来识别患者。患者人口统计数据和临床特征，如年龄、合并症、格里森分期和再入院详细信息。90 天内进行 VTE 并开发风险分层评分系统。所有统计分析均使用 R-Statistical 软件进行，并通过梯度提升决策树 (BRT) 模型估计手术 90 天内发生 VTE 的风险。1.1% (6/522) 的患者在微创前列腺切除术后 3 个月内出现深静脉血栓或肺栓塞。统计分析表明，发生 VTE 的患者与未发生 VTE 的患者在体重指数 (p = 0.016)、住院时间 (p < 0.001) 和再入院次数 (p = 0.036) 方面存在显着差异。BRT 分析发现 8 个变量在预测 VTE 方面表现出相对重要性。构建受试者工作曲线（ROC）来评估新模型的辨别力。该模型的 AUC 为 0.97（95% 置信区间 [CI]：0.945,0.999）。对于预测 VTE，单中心研究存在局限性。在未接受低分子量肝素预防的男性中，微创前列腺切除术后 VTE 的发生率较低（1.1%）。所提出的风险评分系统可能有助于识别高风险患者进行血栓预防。在本报告中，我们研究了连续男性前列腺癌微创根治性前列腺切除术后静脉血栓栓塞的结果。我们利用先进的统计分析开发了一个新的评分系统。我们的结论是，VTE 风险非常低，如果应用我们的模型，可以对前列腺癌根治手术后男性发生 VTE 的风险进行分层。