老年脑出血患者下肢深静脉血栓风险预测模型的构建及验证

The development and validation of a risk prediction model for lower extremity deep venous thrombosis in elderly patients with intracerebral hemorrhage

目的:构建并验证老年脑出血患者发生下肢深静脉血栓的风险预测模型。方法:收集2016年1月至2020年12月温州医科大学附属第一医院住院治疗的953例老年脑出血患者的临床资料,采用单因素分析和多因素Logistic回归分析筛选出下肢深静脉血栓发生的影响因素,构建风险预测模型并用列线图展示,应用ROC曲线下面积评价模型的预测效果,使用Bootstrap重抽样法对模型进行内部验证。结果:年龄、性别、季节、意识障碍、左下肢肌力、D-二聚体浓度是老年脑出血患者发生下肢DVT的独立影响因素。该预测模型的ROC曲线下面积为0.766,敏感度为70.5%,特异度为71.4%,Youden指数为0.418,内部验证C-统计量为0.758。结论:该研究构建的风险预测模型效果良好,可为临床医护人员识别高危患者并及时预防提供依据。

Objective:To develop and verify the risk prediction model of lower extremity deep vein thrombosis(DVT)in elderly patients with intracerebral hemorrhage(ICH).Methods:The clinical data of 953 elderly ICH in-patients in the First Affiliated Hospital of Wenzhou Medical University from January 2016 to December 2020 were collected.DVT associated risk factors of these patients were screened according to univariate analysis and multivariate Logistic regression analysis,after which the risk prediction model was established and the nomogram was drawn.The area under the ROC curve was used to evaluate the predictive effect of the model,and the Bootstrap method was used to internally verify the prediction model.Results:The multivariate regression analysis showed that age,sex,season,disturbance of consciousness,left lower limb muscle strength and D-dimer concentration were independent risk factors of lower limb DVT in elderly patients with intracerebral hemorrhage.The area under ROC curve of the prediction model is 0.766,with the sensitivity 70.5%,specificity 71.4%,Youden index 0.418,and the internal validation C-index 0.758.Conclusion:This model can effectively predict the occurrence of lower limb DVT in elderly patients with intracerebral hemorrhage,and provide basis for clinical medical staff to identify high-risk patients and take measures in time.