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术后自发性脑出血患者早期深静脉血栓形成预测列线图模型的开发

Development of a Predictive Nomogram Model for Early Deep Vein Thrombosis in Postoperative Spontaneous Intracerebral Hemorrhage Patients.

作者信息

Tang Linjun, Xu Yong, Wang Liangwei, Pan Jingjing, Wu Yong

机构信息

Department of Neurosurgery, The Second People's Hospital of Wuhu, Wuhu, People's Republic of China.

出版信息

Int J Gen Med. 2024 Oct 18;17:4793-4803. doi: 10.2147/IJGM.S484611. eCollection 2024.

Abstract

BACKGROUND

This study explores risk determinants for participants' lower extremities deep vein thrombosis (DVT) in the perioperative phase after spontaneous intracerebral hemorrhage (SICH), thereby informing more effective clinical prevention and treatment strategies.

METHODS

During the period spanning October 2021 to March 2024, clinical data from 96 participants who received surgical treatment for spontaneous cerebral hemorrhage was analyzed in a retrospective study. Participants were classified into DVT and negative-DVT groups within the first week post-surgery. We used univariate logistic regression and multivariate logistic regression analyses to assess the impact of various clinical variables on DVT. A nomogram model was constructed to forecast the occurrence of early DVT following SICH surgery. The model's performance was assessed and validated using receiver operating characteristic (ROC) curves and bootstrap resampling.

RESULTS

Among the 96 participants, 46 developed DVT. Significant differences were noted in age, D-dimer levels, fibrinogen degradation products, Caprini scores, and total surgical bleeding volume between the groups. Multivariate analysis revealed that Caprini score (the values of OR, 95% CI, and P are 1.962, 1.124-3.424, and 0.018, respectively) and total surgical bleeding volume (the values of OR, 95% CI, and P are 1.010, 1.002-1.018, and 0.017, respectively) were risk variables contributing to DVT occurrence. The area under the receiver operating characteristic curve was 0.918 (95% CI, 0.821-0.988). The calibration curve showed good prediction accuracy.

CONCLUSION

The Caprini score and total surgical bleeding volume are meaningful self-reliant risk variables contributing to DVT occurrence in postoperative participants with SICH. We have created a straightforward and efficient model to predict early DVT post-SICH surgery. This model serves as a valuable clinical tool for evaluating individual risk and enhancing decision-making processes.

摘要

背景

本研究探讨自发性脑出血(SICH)围手术期参与者下肢深静脉血栓形成(DVT)的风险决定因素,从而为更有效的临床预防和治疗策略提供依据。

方法

在2021年10月至2024年3月期间,对96例接受自发性脑出血手术治疗的参与者的临床资料进行回顾性研究。参与者在术后第一周内被分为DVT组和非DVT组。我们使用单因素逻辑回归和多因素逻辑回归分析来评估各种临床变量对DVT的影响。构建了一个列线图模型来预测SICH手术后早期DVT的发生。使用受试者工作特征(ROC)曲线和自助重采样对模型的性能进行评估和验证。

结果

96例参与者中,46例发生DVT。两组在年龄、D-二聚体水平、纤维蛋白原降解产物、Caprini评分和手术总出血量方面存在显著差异。多因素分析显示,Caprini评分(OR值、95%CI和P值分别为1.962、1.124 - 3.424和0.018)和手术总出血量(OR值、95%CI和P值分别为1.010、1.002 - 1.018和0.017)是导致DVT发生的风险变量。受试者工作特征曲线下面积为0.918(95%CI,0.821 - 0.988)。校准曲线显示出良好的预测准确性。

结论

Caprini评分和手术总出血量是SICH术后参与者发生DVT的有意义的独立风险变量。我们创建了一个简单有效的模型来预测SICH手术后早期DVT。该模型是评估个体风险和加强决策过程的有价值的临床工具。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0007/11495207/948e36d22cd3/IJGM-17-4793-g0001.jpg

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