Douroumis Konstantinos, Kotrotsios Konstantinos, Moulavasilis Napoleon, Fragkiadis Evangelos, Stratigopoulou Panagiota, Adamakis Ioannis, Anastasiou Ioannis, Mitropoulos Dionysios
First Department of Urology, National and Kapodistrian University of Athens, Athens, GRC.
Department of Anesthesiology, Laiko General Hospital of Athens, Athens, GRC.
Cureus. 2025 Feb 8;17(2):e78724. doi: 10.7759/cureus.78724. eCollection 2025 Feb.
Taking into consideration both the increasing number of elderly patients undergoing surgery and the fragility of this particular category of patients, a decisive step towards more effectively balancing venous thromboembolism (VTE) and bleeding risk is the development of a reliable predicting tool. The aim of this study is to appraise the relationship between comorbidity assessment tools and VTE risk assessment models (RAMs) in patients undergoing urological procedures.
Data were prospectively collected during a 20-month period (March 2021-October 2022) including 136 urologic inpatients with a mean age of 66.4 (± 14.4) years. Patients' medical records were reviewed in order to evaluate the comorbidities using the Age-Adjusted Charlson Comorbidity Index (AA-CCI), Cumulative Illness Rating Scale (CIRS), American Society of Anesthesiologists (ASA) score and Index of Co-Existent Diseases (ICED). Venous thromboembolism risk was assessed through the European Association of Urology (EAU) RAM, American Urological Association (AUA) RAM, and Caprini score.
Statistical analysis indicated the presence of a statistically significant relationship between all comorbidity scores and VTE RAMs, with only the CIRS score showing no significant deviations across the EAU RAM risk groups (p=0.111). The positive Kendall's Tau-b coefficient values manifest a positive monotonic relationship between the two variables, meaning that higher comorbidity scores correspond to higher VTE risk categories.
Comorbidity scores and VTE RAMs demonstrate a high degree of concordance. This finding suggests that EAU and AUA RAMs, irrespective of their simplicity, can effectively incorporate underlying health conditions and constitute reliable alternatives to the more complex Caprini score.
考虑到接受手术的老年患者数量不断增加以及这类患者的脆弱性，开发一种可靠的预测工具是朝着更有效地平衡静脉血栓栓塞（VTE）和出血风险迈出的决定性一步。本研究的目的是评估接受泌尿外科手术患者的合并症评估工具与VTE风险评估模型（RAMs）之间的关系。
在20个月期间（2021年3月至2022年10月）前瞻性收集数据，包括136名泌尿外科住院患者，平均年龄为66.4（±14.4）岁。回顾患者的病历，以便使用年龄调整的Charlson合并症指数（AA-CCI）、累积疾病评分量表（CIRS）、美国麻醉医师协会（ASA）评分和共存疾病指数（ICED）评估合并症。通过欧洲泌尿外科学会（EAU）RAM、美国泌尿外科学会（AUA）RAM和Caprini评分评估静脉血栓栓塞风险。
统计分析表明，所有合并症评分与VTE RAMs之间存在统计学显著关系，只有CIRS评分在EAU RAM风险组中未显示出显著偏差（p=0.111）。肯德尔tau-b系数正值表明两个变量之间存在正单调关系，这意味着合并症评分越高，VTE风险类别越高。
合并症评分与VTE RAMs显示出高度一致性。这一发现表明，EAU和AUA RAMs，无论其简单性如何，都可以有效地纳入潜在健康状况，并构成更复杂的Caprini评分的可靠替代方案。
