摘要
BACKGROUD: Venous thromboembolism (VTE) including DVT and pulmonary embolism (PE) can be a devastating complication in postoperative patients which is also considered the most likely to be prevented. The proper assessment and effective identification of high risk factors of DVT are the basis for its prevention. We used the Caprini risk assessment model (Caprini RAM) based on many researches about the validation of DVT risk assessment model, and combined the recommendations reported in American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (9th) and Chinese Orthopaedics Association guideline, to give surgical patients stratified prophylaxis. STUDY DESIGN: Between April 2016 and December 2016, we conducted a controlled trial study in 4 surgical departments including Gynecology Department, Joint Surgery, Spinal Surgery and Urology Surgery. 764 patients were included in control group, and 772 patients were included in intervention group. We used the original assessment and prevention methods in control group, while applied the stratified prophylaxis based on Caprini risk assessment level in intervention group. The incidence of DVT was analyzed using chi-square test, while patients’ hospital day was analyzed by independent t-tests. RESULTS: There was significantly difference in incidence rate of DVT between the two groups (13.09‰ vs. 2.59‰, P < 0.05), while the difference in hospital day was not significantly (10.63 ± 5.80 vs. 10.29 ± 5.18, P > 0.05). Most of the surgical patients were with moderate or high-risk (64.93%). CONCLUSIONS: Nurses could identify DVT risk factors in surgical patients using the Caprini risk assessment scale, and apply targeted stratified prophylaxis according to risk level. This model makes DVT risk assessment and intervention process more standardized and effective. It can also reduce incidence rate of DVT significantly. .
BACKGROUD: Venous thromboembolism (VTE) including DVT and pulmonary embolism (PE) can be a devastating complication in postoperative patients which is also considered the most likely to be prevented. The proper assessment and effective identification of high risk factors of DVT are the basis for its prevention. We used the Caprini risk assessment model (Caprini RAM) based on many researches about the validation of DVT risk assessment model, and combined the recommendations reported in American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (9th) and Chinese Orthopaedics Association guideline, to give surgical patients stratified prophylaxis. STUDY DESIGN: Between April 2016 and December 2016, we conducted a controlled trial study in 4 surgical departments including Gynecology Department, Joint Surgery, Spinal Surgery and Urology Surgery. 764 patients were included in control group, and 772 patients were included in intervention group. We used the original assessment and prevention methods in control group, while applied the stratified prophylaxis based on Caprini risk assessment level in intervention group. The incidence of DVT was analyzed using chi-square test, while patients’ hospital day was analyzed by independent t-tests. RESULTS: There was significantly difference in incidence rate of DVT between the two groups (13.09‰ vs. 2.59‰, P < 0.05), while the difference in hospital day was not significantly (10.63 ± 5.80 vs. 10.29 ± 5.18, P > 0.05). Most of the surgical patients were with moderate or high-risk (64.93%). CONCLUSIONS: Nurses could identify DVT risk factors in surgical patients using the Caprini risk assessment scale, and apply targeted stratified prophylaxis according to risk level. This model makes DVT risk assessment and intervention process more standardized and effective. It can also reduce incidence rate of DVT significantly. .
