Department of Respiratory and Critical Care Medicine, Beijing Shijitan Hospital, 12517Capital Medical University, Beijing, China.
616293School of Statistics and Data Science, Nankai University, Tianjin, China.
Clin Appl Thromb Hemost. 2023 Jan-Dec;29:10760296221151164. doi: 10.1177/10760296221151164.
To develop and validate a risk assessment model (RAM) of venous thromboembolism (VTE) in hospitalized Chinese patients.
We reviewed data from 300 patients with VTE and 300 non-VTE patients at Beijing Shijitan Hospital. The risk factors related to VTE were analyzed, and the VTE RAM (Shijitan (SJT) version) was developed according to the weight of each risk factor. A total of 407 patients with VTE and 533 non-VTE patients were enrolled for external validation. The sensitivity, specificity, Youden index, receiver operating curve (ROC), and area under the ROC curve (AUC) were used to evaluate the performance of VTE RAM (SJT version) compared with Caprini RAM and Padua RAM.
The VTE RAM (SJT version) contained six risk factors (age >60 years, lower limb edema, chronic obstructive pulmonary disease (COPD), central venous catheterization (CVC), VTE history, and D dimer). In the external validation group, for medical patients, the AUC value of SJT RAM (0.82 ± 0.03) is significantly higher than Caprini RAM (0.76 ± 0.04; < 0.05), SJT RAM has a higher sensitivity, specificity, and Youden index than Caprini RAM ( < 0.05), which means that the SJT RAM has a much better predictive value than Caprini RAM. While SJT RAM and Padua RAM have the similar predictive value for medical patients ( > 0.05). For surgical patients, the AUC value of SJT RAM (0.72 ± 0.04) is significantly higher than the value of Padua RAM (0.66 ± 0.04; < 0.05), SJT RAM has a higher sensitivity, specificity, and Youden index than Padua RAM ( < 0.05), which shows that the VTE RAM has better predictive value than Padua RAM. While SJT RAM and Caprini RAM have the similar predictive value for surgical patients ( > 0.05).
The SJT RAM derived from general hospitalized Chinese patients will be time-saving for physicians and has a better predictive ability for patients at risk of VTE.
开发和验证一种用于评估中国住院患者静脉血栓栓塞症（VTE）风险的模型（RAM）。
我们回顾了 300 例 VTE 患者和 300 例非 VTE 患者在北京世纪坛医院的数据。分析了与 VTE 相关的危险因素，并根据每个危险因素的权重制定了 VTE RAM（世坛（SJT）版本）。共有 407 例 VTE 患者和 533 例非 VTE 患者纳入外部验证。采用灵敏度、特异度、约登指数、受试者工作特征曲线（ROC）和 ROC 曲线下面积（AUC）来评估 VTE RAM（SJT 版本）与 Caprini RAM 和 Padua RAM 的性能。
VTE RAM（SJT 版本）包含 6 个危险因素（年龄>60 岁、下肢水肿、慢性阻塞性肺疾病（COPD）、中心静脉置管（CVC）、VTE 病史和 D 二聚体）。在外部验证组中，对于内科患者，SJT RAM（0.82±0.03）的 AUC 值明显高于 Caprini RAM（0.76±0.04；<0.05），SJT RAM 的灵敏度、特异度和约登指数均高于 Caprini RAM（<0.05），表明 SJT RAM 的预测价值明显优于 Caprini RAM。而 SJT RAM 和 Padua RAM 对内科患者的预测价值相似（>0.05）。对于外科患者，SJT RAM（0.72±0.04）的 AUC 值明显高于 Padua RAM（0.66±0.04；<0.05），SJT RAM 的灵敏度、特异度和约登指数均高于 Padua RAM（<0.05），表明 SJT RAM 的预测价值优于 Padua RAM。而 SJT RAM 和 Caprini RAM 对外科患者的预测价值相似（>0.05）。
来源于中国一般住院患者的 SJT RAM 将为医生节省时间，并对 VTE 风险患者具有更好的预测能力。
