Jin Zhen-Yi, Li Chun-Min, Zheng Kai, Qu Hong, Yang Wen-Tao, Wen Jia-Hao, Zhang Wang-De, Ren Hua-Liang
Department of Vascular Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.
Int J Gynaecol Obstet. 2024 Jan;164(1):324-333. doi: 10.1002/ijgo.15050. Epub 2023 Aug 19.
To investigate the incidence of isolated distal deep venous thrombosis (IDDVT) concurrent with pulmonary embolism (PE) in gynecologic inpatients, analyze the risk factors for IDDVT with PE, and establish a nomogram model for IDDVT patients with PE.
A total of 260 patients were diagnosed with IDDVT between December 2017 and November 2020. The incidence of PE in these patients was determined using computed tomography pulmonary angiography. Logistic regression analysis was used to identify the related risk factors. On this basis, nomogram risk prediction models were established.
Among 260 patients with IDDVT, 106 (40.8%) had concurrent PE, of whom 74 (28.5%) experienced silent PE. Univariate logistic analysis demonstrated statistical significance for body mass index (BMI; P = 0.044), glucocorticoid therapy (P = 0.009), hypertension (P < 0.001), and diabetes (P < 0.001). Multivariate logistic analysis revealed that these were independent risk factors for IDDVT with PE that retained statistical significance. A nomogram based on these factors was constructed to predict PE in patients with IDDVT. Its receiver operating characteristic (ROC) showed an area under the curve of 0.710 (95% confidence interval 0.642-0.779), with prediction sensitivity of 64.2% and prediction specificity of 76.6%.
In the present study, a high prevalence of PE was found in gynecologic inpatients with IDDVT. Glucocorticoid therapy, hypertension, diabetes, and BMI were independent risk factors for IDDVT patients with PE. Taking these risk factors into account, a nomogram risk prediction model was developed to help facilitate early detection of concurrent PE.
探讨妇科住院患者孤立性远端深静脉血栓形成（IDDVT）合并肺栓塞（PE）的发生率，分析IDDVT合并PE的危险因素，并建立IDDVT合并PE患者的列线图模型。
选取2017年12月至2020年11月期间诊断为IDDVT的260例患者。采用计算机断层扫描肺动脉造影确定这些患者中PE的发生率。采用Logistic回归分析确定相关危险因素。在此基础上，建立列线图风险预测模型。
260例IDDVT患者中，106例（40.8%）合并PE，其中74例（28.5%）为无症状PE。单因素Logistic分析显示，体重指数（BMI；P = 0.044）、糖皮质激素治疗（P = 0.009）、高血压（P < 0.001）和糖尿病（P < 0.001）具有统计学意义。多因素Logistic分析显示，这些是IDDVT合并PE的独立危险因素，且具有统计学意义。基于这些因素构建了列线图，以预测IDDVT患者的PE。其受试者工作特征（ROC）曲线下面积为0.710（95%置信区间0.642 - 0.779），预测敏感性为64.2%，预测特异性为76.6%。
在本研究中，发现妇科IDDVT住院患者中PE的患病率较高。糖皮质激素治疗﹑高血压﹑糖尿病和BMI是IDDVT合并PE患者的独立危险因素。考虑到这些危险因素，开发了列线图风险预测模型，以帮助促进对并发PE的早期检测。
