Caprini和Pauda风险评估模型联合使用对筛选内科住院患者静脉血栓栓塞症的应用价值

Value of combination of Caprini and Padua risk assessment models for venous thromboembolism screening in patients in department of internal medicine

目的 验证Caprini 和Padua 风险评估模型联合使用在内科住院患者中筛选静脉血栓栓塞症(VTE)的有效性。方法 采用单中心回顾性研究,分析从2017 年8~12 月青岛大学附属医院内科住院患者资料,以Caprini 和Padua 风险评估模型对所有患者进行回顾性血栓风险评分,并通过Logistic 二分类回归分析得到Caprini 和Padua 联合使用后的预测概率模型,分别绘制3 种模型的受试者工作特征曲线(ROC),采用Delong 法比较3 种模型的曲线下面积(AUC),以Youden 指数最大的分界点作为最佳诊断分界点。结果 Caprini 和Padua 联合使用后的预测概率模型ROC 曲线下面积高于Caprini 模型和Padua 模型(0.927±0.009 vs 0.739±0.020 vs 0.817±0.017),差异具有统计学意义(Z=10.659,Z=8.952,P 均< 0.001)。并且预测概率模型灵敏度及特异度均大于Caprini 或Padua(83.7% vs 79.1% vs 72.1%;87.9% vs 66.7% vs 82.7%)。结论 Caprini 和Padua 风险评估模型联合使用可提高筛选内科住院患者VTE 的准确性。

Objective To verify the efficacy of Caprini and Padua risk assessment models of screening for venous thromboembolism (VTE) in patients in the department of internal medicine. Methods A single center retrospective study was performed in the medical inpatients in the affiliated hospitalof of Qingdao University from August 2017 to Decembe.The Padua and Caprini risk score were record retrospectively for each patients,.meanwhile,by using of logistic bivariate regression analysis, we have obtained the predicted probability of Caprini and Padua in combination diagnsis.we have drawn operating characteristic curves (ROC) and calculate the area under the curve (AUC), then we have done pairwise comparison severally. The youden index was taken as the cutoff point. Results The area under the ROC curve of the predictive probability model was all higher than that of Caprini and Padua models, and the difference was statistically significant (P < 0.05).The sensitivity and specificity of predictive probabilistic model are higher than that of Caprini or Padua.Conclusion the combination of Caprini and Padua risk assessment models can improve the accuracy of screening for venous thromboembolism (VTE) in patients in the department of internal medicine.