风险评估概况在指导创伤患者的双功超声监测方面并不理想。
The Risk Assessment Profile is suboptimal for guiding duplex ultrasound surveillance in trauma patients.
作者信息
Kay Annika Bickford, Morris David S, Woller Scott C, Stevens Scott M, Bledsoe Joseph R, Collingridge Dave S, Jacobs Jason R, Majercik Sarah
机构信息
Division of Trauma Services and Surgical Critical Care, Intermountain Medical Center, Murray, UT, USA.
Department of Medicine, Intermountain Medical Center, Murray, UT, USA.
出版信息
Surg Pract Sci. 2022 Sep 6;11:100127. doi: 10.1016/j.sipas.2022.100127. eCollection 2022 Dec.
BACKGROUND
The utility of the Risk Assessment Profile (RAP) score in predicting VTE was assessed, and VTE risk factors identified to guide a duplex ultrasound (DUS) protocol in injured patients.
METHODS
Secondary analysis of prospective data on trauma inpatients (March 2017-September 2019), with admission RAP ≥5. Inhospital VTE patients compared to those without. Regression analyses in DVT, PE and proximal DVT, and ROC analysis evaluating RAP's VTE predictability were performed.
RESULTS
1989 patients were analyzed. VTE was identified in 163(8.2%), DVT 159(8.0%), and PE 10(0.5%) patients. Strongest VTE predictors were massive transfusion (OR 5.97, = 0.005) and spinal cord injury (OR 2.43, = 0.03). AUC 0.61 ( 0.001) on ROC analysis evaluating RAP on VTE. Abdominal injury and major surgery were unique risk factors to non-screened patients.
CONCLUSION
Performance of RAP to predict VTE was moderate. VTE predictor variables could serve as the foundation for a novel approach guiding DUS surveillance. Derivation and validation are warranted.
背景
评估风险评估概况（RAP）评分在预测静脉血栓栓塞症（VTE）方面的效用，并确定VTE风险因素以指导对受伤患者进行双功超声（DUS）检查的方案。
方法
对创伤住院患者（2017年3月至2019年9月）的前瞻性数据进行二次分析，入院时RAP≥5。将住院期间发生VTE的患者与未发生VTE的患者进行比较。对深静脉血栓形成（DVT）、肺栓塞（PE）和近端DVT进行回归分析，并进行ROC分析以评估RAP对VTE的预测能力。
结果
对1989例患者进行了分析。163例（8.2%）患者发生VTE，159例（8.0%）发生DVT，10例（0.5%）发生PE。最强的VTE预测因素是大量输血（OR 5.97，P = 0.005）和脊髓损伤（OR 2.43，P = 0.03）。在评估RAP对VTE的ROC分析中，AUC为0.61（P < 0.001）。腹部损伤和大手术是未接受筛查患者的独特风险因素。
结论
RAP预测VTE的性能中等。VTE预测变量可为指导DUS监测的新方法奠定基础。有必要进行推导和验证。
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