一个系统的评估和对早期预测后血栓塞综合征的元分析
Tong Yu1, Jialin Song2, LingKe Yu3
1Pharmacy Laboratory, College of Pharmacy, Shenyang Pharmaceutical University, Benxi, China.
Frontiers in cardiovascular medicine
|September 11, 2023
概括
血栓后综合征 (PTS) 影响37.5%的深静脉血栓症患者在两年内. 结合年龄和肥胖等因素的早期预测模型可以帮助识别有针对性的预防策略的高风险个人.
科学领域:
- 血管医学 血管医学
- 临床流行病学临床流行病学
- 生物统计学 生物统计学
背景情况:
- 血栓后综合征 (PTS) 是深静脉血栓症 (DVT) 后的一个显著的长期并发症.
- 对PTS有效的预防策略至关重要,但由于早期预测的困难,具有挑战性.
- 现有的PTS预测模型已经显示出有争议的实用性和适用性.
研究的目的:
- 系统地评估PTS的发生率.
- 评估PTS发展早期临床因素的可行性和预测价值.
- 调查PTS风险预测模型的性能.
主要方法:
- 在主要数据库 (PubMed,Embase,Cochrane,Web of Science) 进行系统的文献搜索,直到2023年4月.
- 使用纽卡斯尔-太华尺度 (NOS) 进行包含研究的质量评估.
- 对独立预测因子和预测模型的性能指标 (c指数,灵敏度,特异性) 的几率比率 (OR) 的元分析.
主要成果:
- 在20项研究中的8,512名受试者中,PTS的2年发病率为37.5% (95% CI:27.8-47.7%).
- 对于PTS的显著早期预测因素包括年龄 (OR=1.840),肥胖 (OR=1.721),近距离DVT (OR=2.335),先前的VTE (OR=3.593),吸烟 (OR=2.051),静脉 (OR=2.405) 和基线维拉拉塔得分 (OR=1.095).
- 风险预测模型表现良好,训练组的c指数为0.77,验证组的c指数为0.74.
结论:
- PTS是DVT后的常见和重大并发症,需要有效的管理策略.
- 结合已识别的临床因素的早期风险预测模型是可行的,并且对临床实践有价值.
- 基于风险分层的个性化预防计划可以帮助减少PTS的发生率.
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