Elevated C-reactive Protein and D-dimer to predict Venous Thromboembolism in Patients with Bladder Cancer

Bo Chen¹Tonghe Zhang¹Yisong Wang¹Zhaoyang Li^1,2Haoyu Liu¹Zhan Jiang¹Huitang Yang¹Yandong Cai¹Guoju Fan¹Kaiqiang Wang¹Hongwei Zhang¹Hailong Hu¹Yankui Li^1*

• ¹The Second Hospital of Tianjin Medical University, Tianjin, China
• ²Hebei University, Baoding, China

Objective: This study evaluated C-reactive protein (CRP) in hospitalized patients with bladder cancer (BC) and explored the predictive value of CRP for venous thromboembolism (VTE), combining CRP and D-dimer (D-D) levels to improve the ability to predict the risk of VTE in BC patients, thereby better guiding clinical prevention and treatment of this disease. Methods: Clinical data from 4,438 patients with BC admitted between January 2015 and December 2020 were reviewed. After screening, 2,164 patients remained.52 VTE cases were identified, and 104 matched controls were selected (1:2 ratio). Conditional logistic regression, receiver operating characteristic (ROC) curve analysis, stratified analysis, and interaction tests were conducted to assess predictive performance and control for confounding bias. Results: Conditional logistic regression analysis indicated that elevated CRP and D-D levels were associated with higher risk of VTE in hospitalized patients with BC. Moreover, the areas under the ROC curves were 0.734 for CRP, 0.817 for D-D, and 0.865 for the combined model, indicating that the combined model offers superior predictive performance. Stratified and interaction analyses further revealed that the predictive value of CRP and D-D levels was influenced by the infection status. Conclusion: Elevated CRP and D-D levels may be potential indicators of VTE in BC patients. Their combined use improves predictive accuracy, and their predictive value may be better in non-infected patients.