两种用于妇科手术患者静脉血栓栓塞风险评估模型的验证
Validation of two risk assessment models for venous thromboembolism in patients undergoing gynecologic surgery.
作者信息
Guo Tao, Li Miaomiao, Sang Cui-Qin, Zhang Zhen-Yu, Guo Ruijun, Lu Ruigang, Qu Peng, Cao Wen, Zhao Wei, Li Bin, Wang Jian-Liu, Zhai Jian-Jun, Song Lei, Zhang Zhi-Qiang
机构信息
Department of Obstetrics and Gynecology, Beijing Chao-yang Hospital, Capital Medical University, Beijing, China.
Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, China.
出版信息
Ann Transl Med. 2022 Jan;10(1):18. doi: 10.21037/atm-21-6284.
BACKGROUND
According to published guidelines, gynecologic surgical patients should be stratified into different risk level groups to receive prophylaxis for venous thromboembolism (VTE), but the applicability of available risk assessment models (RAMs) in common gynecologic surgical patients remained to be confirmed. We aimed to validate the use of the Caprini RAM and gynecologic Caprini (G-Caprini) RAM for assessing postoperative VTE risk in gynecologic surgical patients.
METHODS
The database of a randomized controlled trial (RCT) was used to select patients who underwent gynecologic surgeries for benignant and malignant diseases in five institutions in China between 2011 and 2018. The Caprini RAM version recommended by the American College of Chest Physicians (ACCP) was adopted. Participants were divided into four risk levels based on the Caprini and G-Caprini scores. For each risk level group, the incidence of VTE was calculated. The correlation between VET incidence and risk levels was assessed by Spearman's rank correlation coefficient (RS) value.
RESULTS
As a result, 800 patients in the data base were analyzed with an overall VTE incidence of 5.8%. Caprini RAM showed that the percentage of patients at very low risk, low risk, moderate risk, and high risk were 0%, 4.3%, 44.4%, and 51.4%, respectively, and the VTE incidence was 2.9%, 2.3%, and 9.0%, respectively. RS value between the risk stratification and VTE incidence was 0.500 (P=0.667). G-Caprini RAM showed that the percentage of patients at very low risk, low risk, moderate risk, and high risk were 7.8%, 28.0%, 32.0%, and 32.3%, respectively, and the VTE incidence was 0.0%, 2.9%, 2.3%, and 9.0%, respectively. RS value between the risk stratification and VTE incidence was 1.000 (P<0.01).
CONCLUSIONS
The G-Caprini RAM was as suitable as the Caprini RAM for VTE risk assessment in gynecologic surgical patients. The gynecologic model has the advantages of ease of use and more accurate identification of low-risk groups.
背景
根据已发表的指南，妇科手术患者应被分层到不同风险水平组以接受静脉血栓栓塞症（VTE）预防，但现有风险评估模型（RAMs）在普通妇科手术患者中的适用性仍有待确认。我们旨在验证Caprini风险评估模型（RAM）和妇科Caprini（G-Caprini）风险评估模型在评估妇科手术患者术后VTE风险中的应用。
方法
使用一项随机对照试验（RCT）的数据库，选取2011年至2018年期间在中国五家机构接受良性和恶性疾病妇科手术的患者。采用美国胸科医师学会（ACCP）推荐的Caprini风险评估模型版本。根据Caprini和G-Caprini评分将参与者分为四个风险水平。对于每个风险水平组，计算VTE的发生率。通过Spearman等级相关系数（RS）值评估VTE发生率与风险水平之间的相关性。
结果
结果，数据库中的800例患者进行了分析，总体VTE发生率为5.8%。Caprini风险评估模型显示，极低风险、低风险、中度风险和高风险患者的百分比分别为0%、4.3%、44.4%和51.4%，VTE发生率分别为2.9%、2.3%和9.0%。风险分层与VTE发生率之间的RS值为0.500（P=0.667）。G-Caprini风险评估模型显示，极低风险、低风险、中度风险和高风险患者的百分比分别为7.8%、28.0%、32.0%和32.3%，VTE发生率分别为0.0%、2.9%、2.3%和9.0%。风险分层与VTE发生率之间的RS值为1.000（P<0.01）。
结论
G-Caprini风险评估模型在妇科手术患者VTE风险评估中与Caprini风险评估模型一样适用。该妇科模型具有易于使用和更准确识别低风险组的优点。
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