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验证卡普里风险评估模型在中国住院静脉血栓栓塞患者中的应用。

Validation of the Caprini risk assessment model in Chinese hospitalized patients with venous thromboembolism.

机构信息

Respiratory Department, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.

出版信息

Thromb Res. 2012 Nov;130(5):735-40. doi: 10.1016/j.thromres.2012.08.001. Epub 2012 Aug 19.

Abstract

INTRODUCTION

Venous thromboembolism (VTE) occurs frequently in at-risk hospitalized patients, and prophylaxis of VTE is significantly underused. We sought to preliminarily assess the validity of Caprini risk assessment model, a famous individual VTE risk assessment model, in Chinese hospitalized patients with VTE.

MATERIALS AND METHODS

We undertook a retrospective study combined with a follow-up study among 347 confirmed VTE patients from a Chinese hospital.

RESULTS

Compared with the other two risk assessment models (RAMs), Caprini model can classify much more VTE patients into high or highest risk level and the differences were statistically significant (Caprini model vs Kucher model, p<0.0001; Caprini model vs the Padua Prediction Score, p<0.0001). Caprini model exhibited much more effect at assessing patient's VTE risk among surgical patients than nonsurgical patients(average risk score, 5.71 ± 2.54 vs 4.36 ± 2.51, p<0.0001; by Wilcoxon rank sum test, p=0.001 in favor of the prediction effect of the RAM in surgical patients). Kaplan-Meier analysis showed that patients classified into low and highest risk level by Caprini model had increased hazard for VTE recurrence when compared with patients classified into moderate and high risk level, but the result was not statistically significant (p=0.222).

CONCLUSIONS

Our study preliminarily suggests that the Caprini risk assessment model is a practical and effective tool to assess the risk of VTE among unselected Chinese inpatients and may also be useful in predicting the risk of VTE recurrence. However, future studies with control group and prospective validation of the model in Chinese inpatients are needed.

摘要

简介

静脉血栓栓塞症(VTE)在高危住院患者中频繁发生,而 VTE 的预防措施明显未得到充分利用。我们旨在初步评估 Caprini 风险评估模型(一种著名的个体 VTE 风险评估模型)在患有 VTE 的中国住院患者中的有效性。

材料与方法

我们在中国一家医院进行了一项回顾性研究,同时对 347 例确诊 VTE 患者进行了随访研究。

结果

与其他两种风险评估模型(RAM)相比,Caprini 模型能将更多的 VTE 患者分为高风险或极高风险级别,且差异具有统计学意义(Caprini 模型与 Kucher 模型相比,p<0.0001;Caprini 模型与 Padua 预测评分相比,p<0.0001)。Caprini 模型在评估手术患者的 VTE 风险方面比非手术患者更有效(平均风险评分,5.71 ± 2.54 比 4.36 ± 2.51,p<0.0001;Wilcoxon 秩和检验,p=0.001 有利于手术患者的 RAM 预测效果)。Kaplan-Meier 分析显示,与中度和高风险水平的患者相比,Caprini 模型分类为低风险和极高风险水平的患者 VTE 复发的风险增加,但差异无统计学意义(p=0.222)。

结论

我们的研究初步表明,Caprini 风险评估模型是一种评估未选择的中国住院患者 VTE 风险的实用且有效的工具,也可能有助于预测 VTE 复发的风险。然而,需要在未来的研究中对该模型进行有对照组和前瞻性验证。

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