Caprini风险评估模型对围术期全髋关节置换患者深静脉血栓的预测效果分析

Effectiveness of Caprini risk assessment model in predicting deepvein thrombosis in patients with perioperative total hip arthroplasty

  • 摘要: 目的:探讨 Caprini 风险评估模型对围术期全髋关节置换术(THA)患者深静脉血栓(DVT)的预测效果。方法:收集2019年1月至2022年12月在我院脊柱骨病外科行THA的37例围术期确诊DVT的患者作为病例组,对照组以1∶4比例选择同时期入院的148例行THA未发生DVT的患者。根据患者的一般资料进行Caprini评分并确定最佳危险分级,使用受试者工作特征(ROC)曲线评估Caprini重新风险分级的临床预测效能。结果:原始Caprini危险分级预测THA患者术前发生DVT均无统计学意义(P>0.05)。术前Caprini重新危险分级:高危(4分)和极高危(≥5分)的THA患者,其术前发生DVT风险分别为低危THA患者的9.30倍和4.90倍;术后Caprini重新危险分级:中危(8~10分)、高危(11~13分)和极高危(≥14分)的THA患者,术后发生DVT风险分别是低危(5~7分)THA患者的4.86倍、102.00倍和25.50倍;术前 Caprini评分预测THA患者发生DVT的AUC为0.74(P<0.05),最佳临界值为2.5分;术后 Caprini评分预测THA患者发生DVT的AUC为0.81(P<0.05),最佳临界值为8.5分。结论:使用Caprini风险评估模型重新进行危险分级可有效预测围术期THA患者发生DVT的风险。

     

    Abstract: Objective: To explore the predictive effect of Caprini risk assessment model on deep vein thrombosis (DVT) in patients with perioperative total hip arthroplasty (THA). Methods: A total of 37 perioperative DVT patients who underwent THA in the Department of Spine and Orthopedics in the First Affiliated Hospital of Guangxi Medical University from January 2019 to September 2022 were collected as the case group, and 148 patients who underwent THA without DVT in the hospital during the same period were selected as the control group at a ratio of 1:4. According to the general data of patients, Caprini score was performed and the optimal risk classification was determined. Receiver operating characteristics (ROC) curve was used to evaluate the clinical predictive efficacy of Caprini re-risk classification. Results: In the original Caprini risk classification, the DVT risks for THA patients categorized as moderate, high, and very high were 1.24 times, 4.67 times, and 5.53 times higher than those for low-risk patients respectively, but these differences were not statistically significant (P>0.05). Preoperative Caprini re-risk classification: the preoperative DVT risks for THA patients classified as high risk (4 points) and very high risk (≥5 points) were 9.30 times and 4.90 times higher than those for low-risk THA patients respectively, and these differences were statistically significant (P<0.05). Postoperative Caprini rerisk classification: the postoperative DVT risks for THA patients classified as moderate risk (8-10 points), high risk (11-13 points), and very high risk (≥14 points) were 4.86 times, 102.00 times, and 25.50 times higher than those for low-risk THA patients with scores of 5-7 respectively, and all these differences were statistically significant (P<0.05). The AUC of preoperative Caprini score in predicting DVT occurrence in THA patients was 0.74 (P<0.05), with an optimal cutoff value of 2.5; while the AUC of postoperative Caprini score in predicting DVT occurrence in THA patients was 0.81 (P<0.05), with an optimal cutoff value of 8.5. Conclusion: Reassessing the risk classification using the Caprini risk assessment model can effectively predict the perioperative DVT risks in THA patients.

     

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