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张晓勤, 何丹, 黎嘉嘉等. Caprini血栓风险评估量表评估重症住院患者静脉血栓栓塞风险的有效性研究[J]. 四川大学学报(医学版), 2015, 46(5): 732-735.
引用本文: 张晓勤, 何丹, 黎嘉嘉等. Caprini血栓风险评估量表评估重症住院患者静脉血栓栓塞风险的有效性研究[J]. 四川大学学报(医学版), 2015, 46(5): 732-735.
ZHANG Xiao-qin, HE Dan, LI Jia-jia. et al. Validity of Caprini Risk Assessment Scale for Assessing Risk of Venous Thromboembolism in Hospitalized[J]. Journal of Sichuan University (Medical Sciences), 2015, 46(5): 732-735.
Citation: ZHANG Xiao-qin, HE Dan, LI Jia-jia. et al. Validity of Caprini Risk Assessment Scale for Assessing Risk of Venous Thromboembolism in Hospitalized[J]. Journal of Sichuan University (Medical Sciences), 2015, 46(5): 732-735.

Caprini血栓风险评估量表评估重症住院患者静脉血栓栓塞风险的有效性研究

Validity of Caprini Risk Assessment Scale for Assessing Risk of Venous Thromboembolism in Hospitalized

  • 摘要: 目的 回顾性验证Caprini风险评估量表预测重症住院患者静脉血栓栓塞(venous thromboembolism, VTE)风险的有效性。方法 采用病例对照研究设计,连续收集2008年1月至2014年6月本院ICU重症住院患者中确诊的78例VTE患者作为病例组,随机选择同时期入院的156例非VTE重症住院患者作为对照组,回顾性收集患者病史、实验室检查等相关临床资料,依据Caprini风险评估量表对两组患者进行评分及VTE危险度分级。比较两组患者Caprini评分情况,采用多因素logistic回归模型分析VTE危险度分级与重症患者VTE发病风险的关系。结果 VTE组患者Caprini评分(8.7±3.5)高于对照组(4.2±2.6);VTE重症患者中经Caprini评分量表判定为高危和极高危的比例高达88.4%,高于非VTE重症患者,差异有统计学意义( P<0.001)。以Caprini风险评估量表中的危险因素作为自变量进行logistic回归分析显示:卧床内科患者、严重肺部疾病(<1个月)、脓毒症(<1个月)、大手术(<1个月)、恶性肿瘤(既往或现患)、深静脉血栓形成/肺血栓栓塞症(DVT/PTE)疾病史、血栓家族史、多发性创伤(<1个月)等8个危险因素是重症住院患者发生VTE的主要高危因素。Caprini评估量表危险度分级与VTE发病风险相关性分析显示,Caprini评估量表评定为高危和极高危的重症患者与VTE发病存在显著的正相关关系,高危和极高危重症患者VTE的发病风险分别是低危患者的2.042和11.681倍。结论 基于个体危险因素的Caprini血栓风险评估量表可以较好的评估重症患者VTE发病风险,可以在临床推广应用。

     

    Abstract: Objective To test the validity of Caprini risk assessment scale in identifying hospitalized critically ill patients with high venous thromboembolism (VTE) risks. Methods A case-control study was conducted, with 78 VTE patients who were admitted to the ICU of Sichuan Provincial People’s Hospital from February 2008 to June 2014 in the case group, and a randomly selected group of 156 non-VTE patients who were admitted during the same period serving as controls. The medical history, laboratory tests and other related clinical data of the participants were retrieved. Their VTE risks were assessed using the Caprini risk assessment scale. Multivariate logistic regression analysis was performed to establish the association between Caprini VTE risk classification and the presence of VTE. Results VTE patients had a Caprini score of 8.7±3.5, higher than that of the controls (4.2±2.6). More than 88.4% of VTE ill patients were rated as having “high or very high” risk of VTE by Caprini rating scale, significantly higher than the percentage in the controls ( P<0.001). The logistic regression model identified eight risk factors in the Caprini scale as predictors of VTE: bed-bound in internal medicine wards, severe lung disease (<1 month), sepsis (<1 month), large operation (<1 month), malignant tumor (past or prevalence), deep venous thrombosis (DVT)/pulmonary thromboembolism (PTE) history, family history, and thrombosis of multiple trauma (<1 month). The odds ratio of VTE in patients with a high and very high risk as identified by Caprini scale was 2.042 and 11.681, respectively, compared with those with a low risk. Conclusion Caprini risk assessment scale can predict the risk of VTE in hospitalized critically ill patients.

     

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