Risk factors and a risk assessment model for venous thromboembolism in head and neck cancer surgery

Objectives: Although various associations between venous thromboembolism (VTE) and head and neck cancer have been identified, limited data exist regarding the incidence of VTE in patients undergoing surgery for head and neck cancer. This study aims to investigate potential risk factors for VTE development in head and neck cancer patients and establish a risk assessment model to aid in risk stratification for these individuals. Methods: The Cox proportional hazards model, including univariable and multivariable analyses, was used to assess potentially significant risk factors. The competing risk model was employed for validation in the analysis of VTE events. Results: Among the 1,122 patients who underwent surgery for head and neck cancer, the incidence of VTE was found to be 2.3 %, with a mortality rate of 0.4 %. Significantly associated factors for VTE development included older age, smoking, hyperlipidemia, pulmonary disease, high neutrophils, low hemoglobin, high D-Dimer, and operation time > 3 h. Using the VTE risk assessment model for patients undergoing head and neck cancer surgery, the subdistribution hazard risk for VTE development was determined to be 8.96-fold (95 % CI, 1.03-98.19) (P = 0.047) for low-risk patients and 27.47-fold (95 % CI, 3.32-184.54) (P = 0.001) for high-risk patients. Conclusion: The proposed risk assessment model may guide clinicians in stratifying VTE risk and implementing targeted prophylactic measures in head and neck cancer surgery patients.