不同风险评估量表预测多发伤患者深静脉血栓形成风险的效果研究-中华老年骨科与康复电子杂志

文章信息/Info

Title:: Effectiveness of different risk assessment scales in identifying perioperative deep vein thrombosis among patients with polytrauma

Author(s):: Chen Huijuan; Sun Libing.; Trauma center of Peking University People’s Hospital, Beijing 100044, China

摘要:: 目的筛选适用于多发伤患者围术期下肢深静脉血栓（DVT）风险预测的评估工具，帮助医护人员早期准确识别DVT高风险人群，从而针对性给予预防措施，保障高危患者安全。方法　采用病例对照研究，连续收集 2017年6月至2022年10月某创伤救治中心收治的54例多发伤围术期合并DVT患者作为病例组，随机选择同一时期入院的108例非DVT多发伤患者作为对照组。采用受试者工作特征曲线（ROC）判断损伤严重度评分、Caprini 风险评估量表、RAPT风险评估表在多发伤患者围术期DVT的临床预测效能。结果　ISS、Caprini、RAPT量表的曲线下面积分别为：0.623（95% CI：0.544，0.698，P＜0.01）、0.810（95% CI：0.741，0.867，P＜0.01）、0.805（95% CI：0.736，0.863，P＜0.01）。Caprini 评分最佳临界值为11.5分，敏感度和特异度分别为 68.5%和85.2%。结论　Caprini和RAPT量表能够有效预测多发伤患者围术期DVT发生风险，但Caprini评分需重新划分危险分级。

Abstract:: Objective　To screen the evaluation tools suitable for perioperative DVT risk prediction in patients with polytrauma, and guide the medical staff to prevent DVT and ensure the safety of high-risk patients. Methods　A case-control study was conducted. 54 patients with polytrauma and perioperative DVT admitted to a trauma center from June 2017 to October 2022 were selected as the treatment group, and 108 patients with polytrauma without DVT admitted during the same period were randomly selected as the control group. The clinical predictive efficacy of perioperative DVT was determined by receiver operating characteristic curve (ROC), including trauma severity score (ISS), Caprini risk assessment model, and RAPT risk assessment scale. Results　The areas under the ROC curves of ISS, Caprini and RAPT scales were 0.623 (95% CI: 0.544, 0.698, P<0.01), 0.810 (95% CI: 0.741, 0.867, P<0.01) and 0.805 (95% CI: 0.544, 0.698, P<0.01), respectively. 0.736, 0.863, P<0.01). The optimal critical value of Caprini score was 11.5 points, and the sensitivity and specificity were 68.5% and 85.2%, respectively. Conclusion　The Caprini and RAPT scale can effectively predict the high-risk population of preoperative DVT among polytrauma patients, but the Caprini scale needs to be reclassified as a risk stratification.