Predictive Value and Model Construction of Caprini Thrombosis Risk Score and Serum D-D,VEGF and PDGF-B for Postoperative Deep Vein Thrombosis in Patients with Traumatic Fracture
Objective:To explore the predictive value of Caprini thrombosis risk score and serum D-dimer(D-D),vascular endothelial growth factor(VEGF),platelet-derived growth factor B(PDGF-B)for postoperative deep vein thrombosis(DVT)in patients with traumatic fracture,and to construct risk prediction model.Methods:216 hospitalized patients with traumatic fracture admitted to The Affiliated Hospital of Xuzhou Medical University from June 2019 to May 2022 were selected as the research objects.According to the occurrence of postoperative DVT,they were divided into DVT group(62 cases)and non-DVT group(154 cases).The differences of Caprini thrombosis risk score,serum D-D,VEGF,PDGF-B and clinical data between the two groups were compared.Multivariate Logistic regression analysis was used to identify the risk factors of DVT,the prediction model was established,and the model was validated,and the receiver operating characteristic(ROC)curve was drawn for efficacy evaluation.Results:The occurrence rate of postoperative DVT in patients with traumatic fracture was 28.70％.The proportion of patients in the DVT group with the time from fracture to admission greater than 24 hours were more than those in the non-DVT group,and the prothrombin time(PT),activated partial thromboplastin time(APTT),D-D,VEGF,PDGF-B and Caprini thrombosis risk score were higher than those in the non-DVT group(P＜0.05).Multivariate Logistic regression analysis showed that the time from fracture to admission greater than 24 hours,high levels of serum D-D,VEGF,PDGF-B and increased Caprini thrombosis risk score were independent risk factors for the occurrence of postoperative DVT in patients with traumatic fracture(P＜0.05).Logistic regression analysis was used to analyze the 5 independent risk factors of the occurrence of postoperative DVT in patients with traumatic fracture,and the prediction model equation was established as follows:Logit(P)=-0.171+1.170×time from fracture to admission+1.041×serum D-D+0.046×serum VEGF+0.100×serum PDGF-B+0.080×Caprini thrombosis risk score,the internal verification results showed that the C-index count was 0.825(95％CI:0.740～0.892),and the Calibration curve showed that the Calibration curve was close to the ideal curve(P＞0.05).External validation used this study sample:the area under curve(AUC)was 0.901,the sensitivity was 0.887,and the specificity was 0.870,which showed that the model had high predictive efficiency,it was significantly higher than the predictive efficacy of D-D,VEGF,PDGF-B and caprini thrombus risk score alone.Conclusion:The time from fracture to admission,serum D-D,VEGF,PDG and Caprini thrombosis risk score were the influencing factors of the occurrence of postoperative DVT in patients with traumatic fracture,the constructed prediction model had good predictive efficiency for the occurrence of DVT.
Traumatic fractureCaprini thrombosis risk scoreD-DVEGFPDGF-BDeep vein thrombosisModel construction
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