An Integrative Inflammatory Nutritional Model for Predicting Postoperative Venous Thromboembolism in Locally Advanced Gastric Cancer receiving Surgery plus Prophylactic Hyperthermic Intraperitoneal Chemotherapy

Background Risk factors for venous thromboembolism (VTE) in locally advanced gastric cancer (LAGC) patients undergoing radical surgery (RS) plus prophylactic hyperthermic intraperitoneal chemotherapy (p-HIPEC) are unclear. This study aimed to develop a nomogram to predict VTE in this population. Methods A total of 1029 LAGC patients receiving RS plus p-HIPEC at the Affiliated Hospital of Qingdao University (Jan 2019-Mar 2025) were analyzed and were segregated into a training cohort and a temporal validation cohort according to the chronological order of admission in a ratio of 7:3. In the training cohort, logistic regression analysis and LASSO regression were used to construct a model and it was subsequently validated in a temporal validation cohort. Results Of 1029 patients, 130 developed post-surgery VTE. Multivariable logistic regression identified independent risk factors: Caprini score (OR = 1.447, P < 0.001), age (OR = 2.726, P = 0.003), fibrinogen-albumin ratio (OR = 3.543, P = 0.001), visceral-to-subcutaneous adipose tissue area ratio (OR = 2.890, P < 0.001), central venous catheter (OR = 3.175, P < 0.001), D-dimer level (OR = 4.379, P < 0.001), and neutrophil-lymphocyte ratio (OR = 3.149, P = 0.002). The nomogram based on these factors achieved AUCs of 0.885 (training) and 0.880 (validation). Calibration curves showed good agreement, and DCA confirmed high clinical utility. Conclusions We identified VTE risk factors related to inflammation and nutrition in LAGC patients receiving RS with p-HIPEC. The constructed nomogram, incorporating the Caprini score, effectively predicted VTE risk and assisted clinicians in implementing timely preventive and treatment strategies.