Predicting venous thromboembolism of burn patients by venous duplex ultrasonography combined with red blood cell distribu-tion width and platelets to lymphocytes ratio
Objective To investigate the risk of venous thromboembolism(VTE)of burn patients predicted by venous duplex ultrasonography(DUS)combined with red blood cell distribution width(RDW)and platelets to lymphocytes ratio(PLR).Methods A retrospective summary was conducted on 126 burn patients diagnosed in Jinhua Municipal Central Hospital from April 2020 to April 2023.They were routinely followed up for 6 months after treatment and were divided into VTE group of 25 cases and non-VTE group of 101 cases according to venous angiography as the gold standard.Before treatment,DUS was used to measure lumen diameter and peak flow velocity of the deep veins in the lower limbs,and experienced ultrasound physicians made the qualitative diagnosis of thrombosis.Blood biochemistry including red blood cell count,RDW,platelet count,PLR,and coagulation function were detected.The clinical data,and ultrasound parameters and blood biochemical indicators before treatment were compared between the two groups.The study explored the correlation between peak velocity of deep vein of lower limbs and RDW,D-dimer,fibrinogen(Fib),PLR and the thrombus risk assessment scale(Caprini score).With venous angiography as the gold standard,the value of DUS in qualitative diagnosis of thrombus was analyzed.The values of peak velocity of deep veins of lower limbs,RDW and PLR in VTE diagnosis were also analyzed.Results Compared with the non-VTE group,patients'age and percentage of burn area in total body surface area(TBSA％)were larger in VTE group,and lumen diameter,RDW,D-dimer,and fibrinogen(Fib)levels were significantly higher(all P＜0.05),while peak flow velocity and PLR were significantly less(both P＜0.05).Spearman test showed that peak flow velocity was negatively correlated with RDW,D-dimer,and Fib,while positively correlated with PLR(P＜0.05 for all).The accuracy,sensitivity and specificity of DUS in qualitative diagnosis of thrombosis were 0.889,0.800,0.911,respectively,while the positive and negative predictive values were 0.690,0.948,respectively.The area under curve(AUC)of peak flow velocity,RDW and PLR for predicting VTE using receiver operating curve(ROC)were 0.723,0.698 and 0.623,respectively,and the AUC of peak flow velocity combined with RDW for VTE diagnosis was 0.797,significantly higher than single indicator(all P＜0.05).Conclusion DUS as the preferred non-invasive tool for clinical screening and diagnosis of VTE can provide more blood flow information for VTE by combining quantitative parameters such as peak flow velocity and RDW,which could better predict the occurrence of venous thrombosis in burn patients.
Venous duplex ultrasonographyRed blood cell distribution widthPlatelets to lymphocytes ratioBurnVenous thromboembolism
万方数据
维普
