Li Peng-Fei, Lu Xin, Zhou Yu-Qian, Wang Ke, Yang Peng, Chen Xiong-Hui, Xu Feng
Department of Emergency Medicine, The First Affiliated Hospital of Soochow University, Suzhou 215000, Jiangsu, China.
Chin Med Sci J. 2024 Dec 23;39(4):241-248. doi: 10.24920/004411.
Venous thromboembolism is a highly prevalent condition after polytrauma, and recognized as an important factor contributing to poor prognosis. The aim of this study was to investigate the risk factors for lower extremity deep venous thrombosis (LEDVT) in a severely traumatized population and to evaluate their predictive value for LEDVT.
This was a retrospective, single-center observational study. All subjects were severely traumatized patients who were admitted to the Traumatic Intensive Care Unit from January 2021 to May 2024. Based on Doppler ultrasound findings of both lower extremities from the time of injury to 30 days post-injury, patients who developed LEDVT were enrolled in the LEDVT group, and those who did not develop LEDVT were enrolled in the NLEDVT group. Demographic, clinical, and laboratory data were collected upon admission. Multivariable logistic regression analysis was performed to identify risk factors for LEDVT. Receiver operating characteristic (ROC) curve was used to evaluate the overall fit of the final model.
There were 56 patients enrolled in the LEDVT group and 81 patients in the NLEDVT group.Age, Aggregate Index of Systemic Inflammation (AISI), Systemic Inflammation Response Index (SIRI), ICU length of stay, and albumin were identified as independent risk factors for LEDVT (all < 0.05). The area under their ROC curves were 0.604, 0.657, 0.694, 0.668, and 0.405, respectively. Combined model for early clinical prediction of LEDVT in severely traumatized patients by age, SIRI, AISI, and albumin resulted in an area under the ROC curve of 0.805 (95%: 0.73-0.88, = 0.037).
The combination of age, SIRI, AISI, and albumin has a predictive value for LEDVT in severely traumatized patients.
静脉血栓栓塞症在多发伤后极为常见，且被认为是导致预后不良的重要因素。本研究旨在探讨严重创伤人群下肢深静脉血栓形成（LEDVT）的危险因素，并评估其对LEDVT的预测价值。
这是一项回顾性单中心观察性研究。所有受试者均为2021年1月至2024年5月入住创伤重症监护病房的严重创伤患者。根据受伤至伤后30天双下肢的多普勒超声检查结果，发生LEDVT的患者纳入LEDVT组，未发生LEDVT的患者纳入非LEDVT组。入院时收集人口统计学、临床和实验室数据。进行多变量逻辑回归分析以确定LEDVT的危险因素。采用受试者工作特征（ROC）曲线评估最终模型的整体拟合度。
LEDVT组纳入56例患者，非LEDVT组纳入81例患者。年龄、全身炎症综合指数（AISI）、全身炎症反应指数（SIRI）、重症监护病房住院时间和白蛋白被确定为LEDVT的独立危险因素（均P<0.05）。其ROC曲线下面积分别为0.604、0.657、0.694、0.668和0.405。由年龄、SIRI、AISI和白蛋白组成的严重创伤患者LEDVT早期临床预测联合模型的ROC曲线下面积为0.805（95%：0.73 - 0.88，P = 0.037）。
年龄、SIRI、AISI和白蛋白的组合对严重创伤患者的LEDVT具有预测价值。
