To explore the value of preoperative combined monitoring of platelet aggregation function and coagulation indexes in predicting postoperative complications in elderly patients with gastrointestinal tumors.

A retrospective selection was made of 252 elderly patients with gastrointestinal tumors who were scheduled to undergo radical surgery for gastrointestinal tumors in Jieshou People's Hospital and Bozhou People's Hospital from January 2021 to May 2024. The platelet aggregation function [maximum platelet aggregation rate induced by adenosine diphosphate (ADP-MAR), maximum platelet aggregation rate induced by arachidonic acid (AA-MAR)] and coagulation indicators [prothrombin time (PT), D-dimer (D-D), fibrinogen (FIB), activated partial thromboplastin time (APTT)] of all patients 1 day before the operation were collected. The occurrence of complications within 30 days after the operation was recorded, and the patients were divided into the complication group (74 cases) and the non-complication group (178 cases). The clinical data of the two groups and the factors influencing the occurrence of complications were analyzed, and the predictive efficacy of the influencing factors was evaluated.

The overall incidence of postoperative complications was 29.36% (74/252). There were significant differences between the complication group and the non-complication group in terms of age, ASA classification, TNM stage, surgical method, ADP-MAR, AA-MAR, PT, APTT, FIB, and D-D (P<0.05). Spearman correlation analysis showed that preoperative platelet aggregation function indicators and coagulation indicators were significantly positively correlated with the occurrence of complications (P<0.05). Multivariate Logistic regression model analysis showed that age, ADP-MAR, AA-MAR, FIB, D-D levels, and ASA classification were risk factors affecting the occurrence of postoperative complications in elderly patients with gastrointestinal tumors (P<0.05). ROC curve analysis showed that the AUC of the nomogram model for predicting overall complications was 0.906 (95% CI: 0.860-0.953). The AUC for predicting thrombosis-related complications was 0.923 (95% CI: 0.881-0.965), and the AUC for predicting non-thrombosis-related complications was 0.878 (95% CI: 0.821-0.935).

Preoperative combined monitoring of platelet aggregation function and coagulation indexes, combined with clinical characteristics such as age and ASA classification, can effectively identify patients at high risk of postoperative complications in elderly patients with gastrointestinal tumors. This combined monitoring mode can provide evidence-based basis for clinical development of individualized perioperative management plan, thereby reducing the incidence of postoperative complications and improving the prognosis of patients.