Caprini风险评估模型在神经外科卧床患者静脉血栓栓塞筛选中的应用

Value of Caprini risk assessment model in screening for venous thromboembolism among patients lying in bed in the Department of Neurosurgery

摘要:

目的 探讨Caprini血栓风险评估模型在神经外科卧床患者静脉血栓栓塞（venous thromboembolism，VTE）筛选中的有效性。方法 对2010年1月至2017年8月期间在我院进行过VTE筛查的神经外科卧床患者进行回顾性Caprini风险评估模型评分及VTE风险等级分级，比较是否发生VTE患者的Caprini评分和不同VTE风险等级患者VTE的发生率，采用多因素Logistic回归模型分析VTE风险等级分级与VTE发生风险的关系。结果 VTE发生率为5.4%，低危、中危、高危、极高危组VTE的发生率分别为：0.9%、1.9%、4.8%、10.6%。VTE患者Caprini评分明显高于非VTE患者[6（3~7） v..s.3（2~5）；Z=13.679，P<0.001]。Caprini风险评估模型评定VTE风险等级为高危和极高危卧床患者发生VTE的风险分别是低危患者3.228倍和12.705倍。结论 Caprini风险评估模型能对神经外科卧床患者术后住院期间VTE的发病风险进行预测，尤其是针对VTE发生风险等级为高危和极高危患者，值得临床推广应用。

Abstract:

Objective To investigate the value of Caprini risk assessment model in the screening for venous thromboembolism (VTE) in patients lying in bed in the department of neurosurgery.Methods A retrospective analysis was performed for the clinical data of the patients who were lying in bed and underwent VTE screening in the Department of Neurosurgery in our hospital from January 2010 to August 2017, including Caprini risk assessment model score and VTE risk grade. The Caprini score was compared between the patients with VTE and those without, and the incidence rate of VTE was compared between the patients with different VTE risk grades. A multivariate logistic regression model analysis was performed to investigate the association between VTE risk grade and the risk of VTE.Results The overall incidence rate of VTE was 5.4%, and the incidence rates of VTE in the low-, medium-, high-, and extremely high-risk groups were 0.9%, 1.9%, 4.8%, and 10.6%, respectively. The patients with VTE had a significantly higher Caprini score than those without[6 (3-7) vs 3 (2-5), Z=13.679, P<0.001]. The risks of VTE in the patients lying in bed with high and extremely high risks of VTE assessed by the Caprini risk assessment model were 3.228 and 12.705 times that in those with a low risk of VTE.Conclusions Caprini risk assessment model can be used to predict the risk of VTE during postoperative hospitalization in patients lying in bed in the department of neurosurgery, especially in patients with high and extremely high risks of VTE. Therefore, it holds promise for clinical application.