Risk Prediction and Treatment of LE-DVT in Patients with Chronic Radiation Intestinal Injury: A Retrospective Case–Control Study

Figures & data

Table 1 Modified Subjective/Objective Management Analysis System to Assess the Severity of Bleeding

Grade	Bleeding	Severity	Anemia (Hb, g/L)
1	Mild bleeding	Occasional or occult	Mild anemia (Hb: male ≥ 90~<120 g/L; female ≥ 90~<110 g/L)
2	Moderate bleeding	Persistent	Moderate anemia (Hb: ≥70~<90 g/L)
3	Severe bleeding	Gross	Severe anemia, (Hb: < 70 g/L), transfusion needed

Figure 1 Flow chart of patient selection.

Table 2 Bleeding-Related Data of the Included CRII Patients

n (%)	Total in Study (n = 608)	Total with LE-DVT (n = 32)
CRP	528 (86.8%)	26 (81.3%)
Bleeding	439 (72.2%)	21 (65.6%)
Severity of bleeding
Grade 1	272 (44.7%)	4 (12.5%)
Grade 2	105 (17.3%)	15 (46.9%)
Grade 3	62 (10.2%)	2 (6.3%)
Anemia	387 (63.7%)	29 (90.6%)
Mild anemia (Hb≥ 90 g/L)	173 (28.5%)	5 (15.6%)
Moderate anemia (Hb 70–90 g/L)	135 (22.2%)	17 (53.1%)
Severe anemia (Hb < 70 g/L)	79(13.0%)	7 (21.9%)

Abbreviation: CRP, chronic radiation proctitis.

Table 3 Characteristics of the CRII Patients with or without LE-DVT

Variables	Observation Group (n = 32)	Control Group (n = 576)	p
Age ≥ 50 y, n (%)	25 (78.1)	438 (76.0)	0.788
Male, n (%)	3 (9.4)	72 (12.5)	0.805
BMI < 18.5 kg/m^2, n (%)	6 (18.8)	146 (25.3)	0.382
Cardiovascular and cerebrovascular diseases, n (%)	5 (15.6)	95 (16.5)	0.897
Diabetes mellitus, n (%)	2 (6.3)	70 (12.2)	0.469
Blood transfusion history, n (%)	7 (21.9)	171 (29.8)	0.344
Smoking status, yes, n (%)	0 (0)	13 (2.3)	0.391
Surgical history, n (%)	23 (71.9)	345 (59.9)	0.177
Recent surgical history (≤6 months), n (%)	11 (34.4)	50 (8.7)	0.000
Hemostatic drug use history, n (%)	17 (53.1)	180 (31.3)	0.010
Tumor recurrence or metastasis, n (%)	13 (40.6)	98 (17.0)	0.001
Time to the end of radiotherapy≥24 months, n (%)	9 (28.1)	190 (33.0)	0.568
Corticosteroid treatment, n (%)	18 (56.3)	152(26.7)	0.000
Radiotherapy dose, Gy, median (IQR)	79.0 (69.5–88.5)	80.0 (56.0–86.0)	0.333
Hb, g/L mean ± SD	80.2±16.1	100.4±23.2	0.000
BPC, ×10^9/L, median (IQR)	241.8 (162.1–387.0)	235.0 (186.0–295.5)	0.668
MPV, fl, mean ± SD	8.6±1.4	9.1±1.3	0.054
WBC, ×10^9/L, median (IQR)	5.8 (4.8–10.6)	5.0 (4.0–6.5)	0.003
ALB ≤ 35 g/L, n (%)	18 (56.3)	143 (24.8)	0.000

Note: Data were expressed as means ± SDs, medians (IQR) or n (%).

Abbreviations: BMI, body mass index; IQR, interquartile range; SD, standard deviation; Hb, hemoglobin, BPC, platelet count; MPV, mean platelet volume; WBC, white blood cells; ALB, albumin.

Table 4 Multivariate Logistic Regression Analysis for Developing LE-DVT in CRII Patients After Pelvic Malignancy Radiation

Variables	Coefficient	Standard Error	OR	95% CI Lower Limit~ Higher Limit	p
Recent surgical history (≤6 months)	1.751	0.425	5.761	2.506~13.246	0.000
Tumor recurrence or metastasis	1.115	0.398	3.049	1.398~6.648	0.005
Hb	−0.040	0.010	0.960	0.942~0.979	0.000

Abbreviations: OR, odds ratio; CI, confidence interval; Hb, hemoglobin.

Figure 2 ROC curve of independent factors for predicting LE-DVT development in CRII patients after pelvic malignancy radiation and comparison with the potential prognostic variables.

Abbreviations: ROC, receiver operating characteristic; AUC, area under the receiver-operating characteristic curve; Hb, hemoglobin.