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利用电子病历评估帕多瓦预测评分对以色列非手术住院患者静脉血栓栓塞的预测能力。

Evaluation of the Padua Prediction Score ability to predict venous thromboembolism in Israeli non-surgical hospitalized patients using electronic medical records.

机构信息

Clinical Pharmacology and Toxicology Unit, Carmel Medical Center, Michal St. 7, 3436212, Haifa, Israel.

Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.

出版信息

Sci Rep. 2022 Apr 12;12(1):6121. doi: 10.1038/s41598-022-10209-9.

Abstract

Venous thromboembolism (VTE) is considered a leading safety concern during hospitalization. The Padua Predication Score (PPS) is a risk model conceived to predict VTE among non-surgical hospitalized patients. The study aim was to evaluate the PPS ability to predict VTE in Israeli non-surgical hospitalized patients using data from electronic medical records. A single center, large-scale, historic cohort study of hospitalized non-surgical patients was conducted. Outcomes included clinically diagnosed symptomatic VTE events, bleeding events, and mortality during hospitalization and up to 90 days thereafter, and readmission up to 90 days after discharge. 5117 patient records were analyzed after screening and validation. 1120 (22%) patients were defined per PPS as high-risk, of which 277 (24.7%) were prophylactically treated. The low-risk group included 3997 (78%) patients. Prevalence of symptomatic VTE was low. Overall, 14 (0.27%) VTE events were diagnosed: 3 cases in the high-risk group (0.27%) and 11 (0.28%) in the low-risk group, with no significant difference, p = 0.768. Prophylactic treatment among the high-risk patients did not significantly improve VTE incidence: 1/277 (0.36%) treated vs. 2/843 (0.24%), p = 0.343. There was no significant difference between the study groups regarding the rates of bleeding, unexplained mortality or readmission. PPS was not found to be an efficient tool for identification of non-surgical hospitalized patients with high risk for clinically significant VTE.

摘要

静脉血栓栓塞症(VTE)被认为是住院期间的主要安全隐患。Padua 预测评分(PPS)是一种旨在预测非手术住院患者 VTE 的风险模型。本研究旨在使用电子病历中的数据评估 PPS 预测以色列非手术住院患者 VTE 的能力。进行了一项单中心、大规模、历史性的住院非手术患者队列研究。结局包括临床诊断的有症状 VTE 事件、出血事件和住院期间及之后 90 天内的死亡率,以及出院后 90 天内的再入院率。经过筛选和验证,分析了 5117 份患者记录。根据 PPS,1120 名(22%)患者被定义为高危,其中 277 名(24.7%)接受了预防性治疗。低危组包括 3997 名(78%)患者。有症状 VTE 的患病率较低。总体而言,诊断出 14 例(0.27%)VTE 事件:高危组 3 例(0.27%),低危组 11 例(0.28%),差异无统计学意义,p=0.768。高危患者的预防性治疗并未显著降低 VTE 发生率:277 例中有 1 例(0.36%)接受治疗,843 例中有 2 例(0.24%)接受治疗,p=0.343。两组在出血、不明原因死亡率或再入院率方面无显著差异。研究结果表明,PPS 并不是识别有临床意义 VTE 高风险的非手术住院患者的有效工具。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ff30/9005505/84497e62dadb/41598_2022_10209_Fig1_HTML.jpg

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