Analysis of risk factors and preventive strategies for venous thrombosis in elderly critically ill patients during medium-long catheter indwelling in ICU
Analysis of risk factors and preventive strategies for venous thrombosis in elderly critically ill patients during medium-long catheter indwelling in ICU
Objective To explore the risk factors and preventive strategies for venous thrombosis(VTE)in elderly crit-ically ill patients during medium-long catheter indwelling in intensive care unit(ICU).Methods 278 elderly critically ill pa-tients who underwent medium-long catheter indwelling in Department of Critical Care Medicine,Jiaozhou Central Hospital from January 2020 to April 2023 were selected.According to presence or absence of VTE,they were divided into occurrence group(n=60)and non-occurrence group(n=218).The general data of the two groups were compared.The risk factors for VTE in elderly critically ill patients were analyzed.Receiver operating characteristic(ROC)was used to analyze the predictive value of a regression model for VTE in elderly critically ill patients.Results The age and score of Acute Physiological and Chronic Health Evaluation Ⅱ(APACHE Ⅱ)in the occurrence group were higher than those in the non-occurrence group,the score of Glasgow Coma Scale(GCS)was lower than that in the non-occurrence group,and the incidence of catheter infection was high-er than that in the non-occurrence group(P＜0.05).Logistic regression results showed that patient'age＞80 years,APACHEⅡ score≥20 points,and elevated fibrinogen(Fib)level were independent risk factors for VTE in critically ill elderly patients undergoing medium-long catheter indwelling in ICU(P＜0.05).A regression equation was established for the occurrence of VTE in elderly critically ill patients undergoing medium-long catheter indwelling in ICU:Logit(P)=-6.281+2.560 xage+10.231 xAPACHE Ⅱ score+5.402 x Fib level.The results of Hosmer-Lemeshow test showed that x2=6.324,P=0.511,in-dicating that the model had a good goodness of fit.This risk assessment model was used to predict the data of the deduction group,and the area under ROC curve(AUC)was 0.719(95％CI:0.615-0.809).Conclusion Patients'age＞80 years,APACHE Ⅱ score ≥20 points and elevated Fib may be independent risk factors for VTE in critically ill patients.The assess-ment model based on these risk factors has moderate predictive efficiency for postoperative delayed hemorrhage in critically ill patients.Clinicians should pay attention to the above factors during treatment and actively control disease progression to reduce the risk of VTE.
维普
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