Perioperative coagulation profiling and postoperative lower-extremity venous thrombosis risk prediction in glioma patients.

BACKGROUND: Lower-extremity venous thrombosis (LEVT) is highly prevalent among glioblastoma patients, creating a therapeutic dilemma in clinical management. METHODS: We retrospectively analyzed preoperative coagulation parameters in primary glioma, trigeminal neuralgia, and meningioma patients. Glioma cohorts were stratified by IDH1 and LEVT status, with coagulation factor expression analyzed using public databases. Perioperative coagulation dynamics were evaluated, and an LEVT prediction model was constructed. RESULTS: Glioma patients exhibited a hypercoagulable state compared with non-neoplastic and benign tumor controls, with IDH1-Wt cases showing particularly elevated fibrinogen levels versus IDH1-Mutant gliomas. Perioperative analysis revealed universal decreases in APTT and fibrinogen, while PT prolongation was exclusive to IDH1-Wt cases and APTT shortening predominated in IDH1-Mutant patients. Spatial and single-cell analyses demonstrated IDH1 mutation-specific overexpression patterns of coagulation factors with prognostic significance. LEVT patients were characterized by shorter preoperative APTT, lower postoperative fibrinogen, and distinct coagulation parameter trajectories. These findings informed the development of a high-performance predictive model incorporating perioperative coagulation markers for LEVT risk assessment. CONCLUSION: We characterized perioperative coagulation profiles in glioma patients and developed an accurate LEVT prediction model, enabling early intervention to improve outcomes.