摘要
目的:分析胸外伤患者静脉血栓栓塞症（VTE）的相关因素并建立预测模型。方法:回顾性分析2020年9月至2021年9月上海交通大学附属第六人民医院胸外科诊治的胸外伤787例患者的临床诊治资料，采用单因素和logistic多因素回归分析影响VTE的危险因素，建立预测模型。结果:787例胸外伤患者中VTE 26例，影响VTE的独立危险因素为年龄（OR＝1.162，95%CI：1.089~1.24）、肋骨骨折断端数（≥5）（OR＝13.356，95%CI：1.563~114.132）、合并脑外伤（OR＝6.932，95%CI：1.904~25.234）、腹腔脏器损伤（OR＝34.412，95%CI：6.117~193.59）、上肢骨折（OR＝4.128，95%CI：1.412~12.062）、下肢骨折（OR＝39.688，95%CI：10.749~146.532）、输血（OR＝3.34，95%CI：1.072~10.404）。胸外伤患者VTE概率的ROC曲线下面积（AUC）为0.94（95%CI：0.896~0.983）。结论:年龄、肋骨骨折断端数（≥5）、合并脑外伤、腹腔脏器损伤、上肢骨折、下肢骨折、输血为影响胸外伤患者VTE的独立危险因素，据此建立的风险预测模型可较好的预测VTE的发生，并予以针对性的干预。
Abstract
Objective:To analyze the related factors of venous thromboembolism (VTE) in patients with thoracic trauma, and establish a risk prediction model.Methods:The clinical diagnosis and treatment data of 787 patients with thoracic trauma treated in Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University from September 2020 to September 2021 were retrospectively analyzed. The risk factors affecting VTE were analyzed by univariate and logistic multivariate regression models, and the prediction model was established.Results:Among the 787 patients with thoracic trauma, VTE was found in 26 cases. The independent risk factors affecting VTE were age (OR=1.162, 95%CI: 1.089–1.24), number of rib fractures (≥5) (OR=13.356, 95%CI: 1.563–114.132), complicated with brain trauma (OR=6.932, 95%CI: 1.904–25.234), abdominal viscus injuries (OR=34.412, 95%CI: 6.117–193.59), fracture of upper limb (OR=4.128, 95%CI: 1.412–12.062), fracture of lower limb (OR=39.688, 95%CI: 10.749–146.532), blood transfusion (OR=3.34, 95%CI: 1.072–10.404). The area under ROC curve (AUC) of VTE probability for thoracic trauma patients is 0.94 (95%CI: 0.896–0.983) .Conclusions:Age, number of rib fractures (≥5), complicated with brain trauma, abdominal organ injury, upper limb fracture, lower limb fracture, and blood transfusion are independent risk factors affecting VTE in patients with thoracic trauma. The risk prediction model established on this basis can better predict the occurrence of VTE and provide targeted intervention.
万方数据