Wong Michael Pak-Kai, Zahari Zalina, Abdullah Mohd Shafie, Ramely Rosnelifaizur, Md Hashim Mohd Nizam, Zakaria Zaidi, Zakaria Andee Dzulkarnaen
Hospital Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia; Department of Surgery, School of Medical Sciences, Universiti Sains Malaysia (USM), Kubang Kerian, Kelantan, Malaysia.
Hospital Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia; Faculty of Pharmacy, Universiti Sultan Zainal Abidin (UniSZA), Besut Campus, Besut, Terengganu, Malaysia.
J Vasc Nurs. 2018 Dec;36(4):173-180. doi: 10.1016/j.jvn.2018.07.001. Epub 2018 Aug 6.
Surgical patients are at high risk for developing deep vein thrombosis (DVT). There are many reports concerning DVT, but little is known about silent deep vein thrombosis (sDVT). This study aimed to determine the incidence of sDVT. Secondary objective is to identify the associated factors for the use of DVT prophylaxis and Caprini risk scores among major surgery patients. This prospective observational study involved postoperative surgical patients who are at risk of developing sDVT. The Caprini risk-assessment scores were calculated, and each subject had a preoperative and postoperative compression ultrasound complemented by duplex venous ultrasonography of deep venous system. No patient from the study experienced sDVT. There were significant associations between Caprini risk score group (odds ratio, 8.16; 95% confidence interval [CI], 1.01-68.74; P = .016) and the use of central venous catheter (odds ratio, 6.34; 95% CI, 1.62-24.80; P = .008) with DVT prophylaxis. Interestingly, the use of central venous catheter resulted in more than four-point increment of Caprini risk scores (mean increment, 4.19; 95% CI, 3.16-5.21; P < .001). Besides that, age was also significantly associated with Caprini risk scores (β coefficient, 0.06; 95% CI, 0.02-0.11). Result from our study shows that the sDVT was nonexistent in this study setting. High-Caprini risk score group and the presence of central venous catheter were the significant predictor factors for the use of DVT prophylaxis. Significant predictor factors for Caprini risk scores were age and the presence of central venous catheter.
外科手术患者发生深静脉血栓形成（DVT）的风险很高。关于DVT有很多报道，但对无症状深静脉血栓形成（sDVT）却知之甚少。本研究旨在确定sDVT的发生率。次要目标是确定大手术患者中使用DVT预防措施的相关因素以及Caprini风险评分。这项前瞻性观察性研究纳入了有发生sDVT风险的术后外科手术患者。计算Caprini风险评估评分，每位受试者术前和术后均进行压迫超声检查，并辅以深静脉系统的双功静脉超声检查。该研究中没有患者发生sDVT。Caprini风险评分组（比值比，8.16；95%置信区间[CI]，1.01 - 68.74；P = 0.016）和中心静脉导管的使用（比值比，6.34；95% CI，1.62 - 24.80；P = 0.008）与DVT预防措施之间存在显著关联。有趣的是，中心静脉导管的使用导致Caprini风险评分增加超过4分（平均增加，4.19；95% CI，3.16 - 5.21；P < 0.001）。除此之外，年龄也与Caprini风险评分显著相关（β系数，0.06；95% CI，0.02 - 0.11）。我们的研究结果表明，在本研究环境中不存在sDVT。高Caprini风险评分组和中心静脉导管的存在是使用DVT预防措施的重要预测因素。Caprini风险评分的重要预测因素是年龄和中心静脉导管的存在。
