Frankel Jason, Belanger Matthew, Tortora Joseph, McLaughlin Tara, Staff Ilene, Wagner Joseph
Urology Division, Hartford Healthcare Medical Group, Hartford Hospital, Hartford, USA.
Turk J Urol. 2020 Jan 6;46(2):108-114. doi: 10.5152/tud.2019.19162. Print 2020 Mar.
To evaluate the Caprini score as an independent predictor of venous thromboembolism (VTE) in patients undergoing robotic-assisted radical prostatectomy (RARP) and to identify appropriate cut-points for clinical use.
We performed a retrospective review of patients who underwent RARP for prostate cancer between December 2003 and February 2016. VTE cases developed the condition within 90 days of discharge. The control group was comprised of patients whose RARP most closely preceded and followed each VTE case in time and who were matched on lymph node dissection and surgeon. The Caprini score was calculated for each patient, and the groups were compared on a number of clinical variables. Multiple logistic regression was used to evaluate whether the Caprini score was an independent predictor of VTE. Receiver operating characteristics (ROC) curves were used to establish appropriate clinical cutpoints.
A total of 3719 patients underwent RARP during the study period. A total of 52 (1.4%) of patients met the criteria for cases. Data were available for 97 patients who met the criteria for controls. Multiple logistic regression indicated that the Caprini score and operative time were independently both significant predictors of VTE (p=0.005 and p=0.044, respectively). ROC indicated that the Caprini score showed a significant but moderate relationship to VTE (area under curve [AOC]=0.64; p=0.004). A Caprini score >6 was the best arithmetic balance for sensitivity (61.5; 95% confidence interval [CI]: 47.0-74.7) and specificity (59.8; 95% CI: 49.3-69.6).
The Caprini score predicts postoperative VTE in patients undergoing RARP.
评估Caprini评分作为接受机器人辅助根治性前列腺切除术（RARP）患者静脉血栓栓塞症（VTE）独立预测指标的价值，并确定临床应用的合适切点。
我们对2003年12月至2016年2月期间因前列腺癌接受RARP的患者进行了回顾性研究。VTE病例在出院后90天内发病。对照组由在时间上最接近每个VTE病例前后接受RARP且在淋巴结清扫和手术医生方面匹配的患者组成。计算每位患者的Caprini评分，并比较两组在多个临床变量上的差异。采用多因素logistic回归评估Caprini评分是否为VTE的独立预测指标。使用受试者工作特征（ROC）曲线确定合适的临床切点。
研究期间共有3719例患者接受了RARP。共有52例（1.4%）患者符合病例标准。97例符合对照标准的患者有可用数据。多因素logistic回归表明，Caprini评分和手术时间均为VTE的独立显著预测指标（分别为p = 0.005和p = 0.044）。ROC分析表明，Caprini评分与VTE呈显著但中等强度的相关性（曲线下面积[AUC]=0.64；p = 0.004）。Caprini评分>6时，在敏感性（61.5；95%置信区间[CI]：47.0 - 74.7）和特异性（59.8；95%CI：49.3 - 69.6）方面达到最佳算术平衡。
Caprini评分可预测接受RARP患者的术后VTE。
