Caprini风险评估模型筛选老年急性心力衰竭患者静脉血栓栓塞症的有效性分析

Validity of caprini risk assessment modle for venous thromboembolism in elderly patients with acute heart failure

目的分析Caprini风险评估模型筛选老年急性心力衰竭患者静脉血栓栓塞症(venous thromboembolism,VTE)的价值。方法回顾性收集2017年6月至2020年12月首都医科大学附属北京世纪坛医院心内科收治的老年急性心力衰竭合并VTE患者50例作为VTE组,选择同期未患VTE的老年急性心力衰竭患者100例作为对照组,收集所有患者的相关临床资料并根据Caprini风险评估模型对所有患者进行评分及危险度分级,探讨不同危险度分级与老年急性心力衰竭患者VTE形成风险的关系,采用Logistic回归分析老年急性心力衰竭患者发生VTE的主要危险因素。结果VTE组的Caprini评分明显高于对照组,差异有统计学意义[(7.92±2.17)分vs(5.50±1.83)分,P=0.001];老年急性心力衰竭患者极高危组发生VTE的风险是高危组的22.014倍(95%CI=2.907~166.736,P=0.003)。多因素Logistic回归分析显示,卧床>3 d(OR=7.000,95%CI=2.515~19.483,P=0.001)、肺功能异常(OR=3.678,95%CI=1.014~13.346,P=0.048)及D-二聚体升高(OR=1.001,95%CI=1.000~1.002,P=0.019)是老年急性心力衰竭患者发生VTE的独立危险因素。结论Caprini风险评估模型可有效用于评估老年急性心力衰竭患者静脉血栓栓塞症的风险。

Objective To analyze the effectiveness of the Caprini risk assessment model for venous thromboembolism(VTE)in elderly patients with acute heart failure.Methods A total of 50 elderly acute heart failure patients with VTE who were treated in the Department of Cardiology,Beijing Shijitan Hospital,Capital Medical University,were collected retrospectively from June 2017 to December 2020 as the VTE group,and 100 elderly acute heart failure patients who did not suffer from VTE during the same period were selected as the control group.The relevant clinical data of all patients were collected retrospectively,and the risks of all patients were scored and graded by the Caprini risk assessment model to explore the relationship between degree classification and the risk of VTE in elderly patients with acute heart failure.Logistic regression was used to analyze the main risk factors for VTE in elderly patients with acute heart failure.Results The Caprini score of the VTE group was significantly higher than that of the control group,and the difference was statistically significant(7.92±2.17 vs 5.50±1.83,P=0.001).The risk of VTE in the very high-risk group of elderly acute heart failure patients was 22.014 times that of the high-risk group(95%CI=2.907-166.736,P=0.003).Multivariate logistic regression analysis showed that bed rest for more than 3 days(OR=7.000,95%CI=2.515-19.483,P=0.001),abnormal lung function(OR=3.678,95%CI=1.014-13.346,P=0.048)and high D-dimer value(OR=1.001,95%CI=1.000-1.002,P=0.019)were the independent predictors of the risk of VTE in elderly patients with acute heart failure.Conclusion The Caprini risk assessment model can be effectively used to assess the risk of VTE in elderly patients with acute heart failure.