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构建并验证一种预测肺癌患者静脉血栓栓塞风险的评分系统。

Development and Validation of a Risk Score for Prediction of Venous Thromboembolism in Patients With Lung Cancer.

机构信息

Division of Vascular Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.

Guangzhou Institute of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.

出版信息

Clin Appl Thromb Hemost. 2020 Jan-Dec;26:1076029620910793. doi: 10.1177/1076029620910793.

Abstract

This study aimed to develop and validate a risk score for early prediction of venous thromboembolism (VTE) in patients with lung cancer. A total of 827 patients with lung cancer from February 2013 to February 2018 in our hospital were retrospectively analyzed. Demographic and clinicopathological variables independently correlated to VTE were applied to develop the risk score in the development group while examined in the validation group. The regression coefficients of multivariable logistic regression test were applied to assign a risk score system. The incidence of VTE was 12.3%, 12.7%, and 11.8% in all patients, in the development and validation groups, respectively. The 496 patients in the development group were classified into 3 groups: low risk (scores ≤3), moderate risk (scores 4-5), and high risk (scores ≥6). The risk of VTE was significantly and positively related to the risk scores in both development and validation groups. The risk score system aided proper stratification of patients with either high or low risk of VTE in the development and validation groups ( statistic = 0.819 and 0.827, respectively). This risk score system based on the factors with most significant correlation showed good predictive ability and is potentially useful for predicting VTE in patients with lung cancer. However, it was developed and validated by a retrospective analysis and has significant limitations, and a prospective validation with all the classic variables assessing the thrombotic risk is needed for a solid conclusion.

摘要

本研究旨在开发和验证一种用于预测肺癌患者静脉血栓栓塞症(VTE)的风险评分。回顾性分析了 2013 年 2 月至 2018 年 2 月我院 827 例肺癌患者。在开发组中应用与 VTE 独立相关的人口统计学和临床病理变量来开发风险评分,在验证组中进行检验。多变量逻辑回归检验的回归系数用于分配风险评分系统。所有患者、开发组和验证组的 VTE 发生率分别为 12.3%、12.7%和 11.8%。在开发组的 496 例患者中,分为低危(评分≤3)、中危(评分 4-5)和高危(评分≥6)三组。在开发组和验证组中,VTE 的风险均与风险评分显著正相关。该风险评分系统有助于在开发组和验证组中对 VTE 高危或低危患者进行适当分层(统计学=0.819 和 0.827)。该风险评分系统基于与相关性最显著的因素,具有良好的预测能力,可能有助于预测肺癌患者的 VTE。然而,它是通过回顾性分析开发和验证的,具有显著的局限性,需要前瞻性验证所有评估血栓形成风险的经典变量,才能得出确凿的结论。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/59e6/7288811/d544cfeb1f5d/10.1177_1076029620910793-fig1.jpg

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