Caprini与Khorana风险评估量表对恶性肿瘤患者发生静脉血栓栓塞症的预测价值

Predictive value of Caprini and Khorana risk assessment scales for venous thromboembolism in patients with malignant tumors

目的探讨Caprini与Khorana量表对恶性肿瘤患者静脉血栓栓塞症(VTE)发病风险的预测价值。方法回顾性分析安岳县人民医院2019年1月至2021年12月收治的恶性肿瘤患者的临床资料,观察组为合并VTE的98例患者,对照组为按照接近1:2比例选取的未合并VTE的173例患者。采用ROC曲线探讨Caprini评分与Khorana评分对恶性肿瘤患者发生VTE的预测效果。结果两组患者在Caprini评分和Khorana评分分级中的人数占比差异有统计学意义(P<0.05),Logistic多元回归分析结果显示肿瘤分期、年龄、血小板计数、近2周内化疗史是恶性肿瘤患者发生VTE的危险因素(P<0.05);ROC曲线分析显示,联合预测模型的AUC(0.820,95%CI:0.767~0.872)高于Caprini评分(0.796,95%CI:0.743~0.849)或Khorana评分(0.761,95%CI:0.698~0.823)单独预测的结果(P<0.05)。联合预测模型的敏感度、特异度分别为81.5%和74.8%。结论使用Caprini与Khorana风险评估量表联合预测对恶性肿瘤患者发生VTE的预测价值更高,值得推广。

Objective To explore the predictive value of Caprini and Khorana scales for the risk of venous thromboembolism(VTE)in patients with malignant tumors.Methods Clinical data of malignant tumor patients admitted to Anyue County People′s Hospital from January 2019 to December 2021 were retrospectively analyzed.An observation group had 98 patients with VTE,and a control group had 173 patients without VTE.The ratio of patients in the two groups was nearly 1:2.ROC curve analysis was used to analyze the predictive effect of Caprini score and Khorana score on the occurrence of VTE in patients with malignant tumors.Results There were significantly differences in number of patients in the Caprini score and Khorana score between the two groups(P<0.05).Multinomial logistic regression analysis showed that tumor stage,age,platelet count,and chemotherapy history within past 2 weeks were risk factors for VTE in these cancer patients(P<0.05).ROC curve analysis showed that the area under curve(AUC)of the combined prediction model was 0.820(95%CI:0.767~0.872).This was higher than 0.796(95%CI:0.743~0.849)of Caprini score or 0.761(95%CI:0.698~0.823)of Khorana score.The sensitivity and specificity of the combined prediction model were 81.5%and 74.8%,respectively.Conclusions The combined detection of Caprini and Khorana risk assessment scale has a higher predictive value for the incidence of VTE in patients with malignant tumors.It is worthy of promotion.