基于Padua评分预测呼吸内科住院患者发生VTE的优化研究
Optimization study on predicting VTE of inpatients in respiratory medicine department based on Padua score
沈委 1史鹏飞 1王保兰 1马婷 1朱蓉 1王立新1
作者信息
- 1. 南京医科大学淮安市第一人民医院呼吸与危重症医学科(江苏淮安 223001)
- 折叠
摘要
目的 探究呼吸内科患者危险因素与静脉血栓栓塞症(VTE)发生的相关性,根据其相关性对针对Padua评分预测呼吸内科住院患者VTE的发生进行评估量表的优化,并验证改良后的评估模型对VTE预测的有效性.方法 采用了回顾性研究,以2019年3月-2023年7月于淮安市第一人民医院呼吸内科住院患者中考虑为住院期间发生VTE的51例患者为VTE组,选取同时期出院诊断非VTE的1600例患者为非VTE组,回顾性收集2组患者病史、实验室检查结果等临床资料,并分析临床资料与VTE发生的相关性,将高度相关的危险因素加入Pauda评分,并对所有患者进行改良Padua风险评估模型评分,并在验证组中进行验证,比较2种风险评估模型评分情况,验证改良Padua评分的有效性.结果 通过秩和检验发现基础信息中的年龄、BMI、住院天数,实验室检查中的平均红细胞体积、降钙素原定量、白蛋白、谷丙转氨酶、谷草转氨酶、尿素、D-二聚体与VTE发生有统计学差异(P＜0.05),通过单因素和多因素Logistic回归分析发现新增的低蛋白血症(OR=2.972)、输血(OR=47.035)、机械通气(OR=6.782)是发生VTE的高危风险因素(P＜0.05),通过接受者操作特征曲线分析对比改良Padua评分和Padua评分可发现,改良量表的灵敏度和特异度较原版量表有所提高,AUC差异为0.058,Z检验值为2.442,有统计学差异(P＜0.05).结论 改良Padua评分对呼吸内科住院患者进行VTE预测的能力优于原版Padua评分.
Abstract
Objective To explore the correlation between risk factors in respiratory department patients and the occurrence of venous thromboembolism(VTE),and to evaluate the optimization of the Padua score for predicting VTE occurrence in hospitalized respiratory patients based on these correlations.The effectiveness of the modified assessment model for VTE prediction was also validated.Methods A retrospective study was conducted,involving 51 VTE patients who were hospitalized in the Respiratory Department of Huaian First People's Hospital from March 2019 to July 2023.These patients were compared with 1,600 non-VTE patients who were discharged during the same period.Clinical data,including medical history and laboratory test results,were retrospectively collected from both groups.The correlation between clinical data and VTE occurrence was analyzed,and highly relevant risk factors were incorporated into the Padua score.The modified Padua risk assessment model was applied to all patients and validated in a validation group.The scores from both the original and modified risk assessment models were compared to evaluate the effectiveness of the modified Padua score.Results Rank sum tests showed significant differences in basic information,such as age,BMI,and length of hospital stay,as well as laboratory tests including mean corpuscular volume,procalcitonin,albumin,alanine aminotransferase,aspartate aminotransferase,urea,and D-dimer(P＜0.05).Univariate and multivariate logistic regression analyses revealed that newly identified high-risk factors for VTE included hypoalbuminemia(OR=2.972),blood transfusion(OR=47.035),and mechanical ventilation(OR=6.782)(P＜0.05).Receiver operating characteristic curve analysis showed that the sensitivity and specificity of the modified Padua score were higher than those of the original version.The area under the curve(AUC)difference was 0.058,with a Z-test value of2.442,showing statistical significance(P＜0.05).Conclusions The modified Padua score demonstrated superior predictive ability for VTE in hospitalized respiratory patients compared to the original Padua score.
关键词
静脉血栓栓塞症/Padua量表/改良Padua量表Key words
venous thromboembolism/Padua scale/Improved Padua scale引用本文复制引用
出版年
2024
NETL
NSTL
万方数据