ICU⁃VTE评分表在国内重症病人静脉血栓栓塞症风险预测中的有效性研究

Effectiveness of ICU⁃VTE score in risk prediction of venous thromboembolism in critically ill patients in China

目的:探讨ICU⁃VTE评分表在国内重症病人静脉血栓栓塞症(VTE)风险预测中的有效性及重症监护病房(ICU)病人静脉血栓形成的影响因素。方法:采用自制ICU病人一般资料表和ICU⁃VTE评分表收集2018年6月—2021年6月重庆医科大学附属第一医院重症医学科收治的464例病人的相关数据,分析ICU⁃VTE评分对病人VTE的预测效果,并根据是否发生VTE分成两组,分析ICU病人静脉血栓形成的影响因素。结果:464例病人中72例(15.5%)病人发生VTE;ICU⁃VTE得分0~8分的病人占65.9%,9~14分的病人占33.5%,15~18分的病人占0.6%;VTE组病人ICU⁃VTE得分[(9.5±3.3)分]高于非VTE组[(6.2±3.7)分],两组比较差异有统计学意义(P<0.001);ICU⁃VTE预测VTE ROC曲线下面积(AUC)为0.741,敏感度为69.44%,特异度为64.03%;Logistic回归分析显示,年龄增长(OR=1.027)、D⁃二聚体升高(OR=1.028)、有VTE疾病史(OR=7.438)、有创机械通气(OR=2.626)、不能活动≥4 d(OR=5.343)和血小板>250×109/L(OR=2.190)是ICU病人VTE形成的独立危险因素。结论:ICU⁃VTE评分表对国内ICU病人VTE风险预测具有较好的效果,在应用该评分表评估时应关注病人的年龄及D⁃二聚体水平。

Objective:To investigate the effectiveness of the ICU⁃VTE score in predicting the risk of venous thromboembolism(VTE)in intensive care unit(ICU)patients in China and the influencing factors of venous thrombosis in ICU patients.Methods:The data of 464 patients admitted to the Department of Critical Care Medicine,The First Affiliated Hospital of Chongqing Medical University from June 2018 to June 2021 were collected using the self⁃made general data questionnaire for ICU patients and ICU⁃VTE score.Then analyzing the predictive effect of ICU⁃VTE score on VTE.The patients were divided into two groups according to the incident of VET,and the influencing factors of venous thrombosis in ICU patients were analyzed.Results:Among the 464 patients,72(15.5%)patients developed VTE;65.9%of all patients scored(0⁃8)points in ICU⁃VTE score,33.5%of all patients scored(9⁃14)points,and 0.6%of all patients scored(15⁃18)points.The ICU⁃VTE score of the patients in the VTE group[(9.5±3.3)points]was higher than that in the non⁃VTE group[(6.2±3.7)],and the difference between the two groups was statistically significant(P<0.001).The area under the ROC curve of ICU⁃VTE score in prediction of VTE was 0.741,the sensitivity was 69.44%,and the specificity was 64.03%.The Logistic regression analysis showed that age increased(OR=1.027),increased D⁃dimer(OR=1.028),a history of VTE disease(OR=7.438),invasive mechanical ventilation(OR=2.626),immobility≥4 days(OR=5.343),and platelets>250×109/L(OR=2.190)were independent risk factors for VTE in ICU patients.Conclusions:The ICU⁃VTE score had a good effect in predicting VTE risk in ICU patients in China.The age and D⁃dimer level of the patients should be paid attention to when using the ICU⁃VTE score.