风险评估概况对于指导创伤患者的双重超声监测是不理想的
Annika Bickford Kay1, David S Morris1, Scott C Woller2,3
1Division of Trauma Services and Surgical Critical Care, Intermountain Medical Center, Murray, UT, USA.
Surgery in practice and science
|January 23, 2025
概括
风险评估概况 (RAP) 评分适度预测受伤患者的静脉血栓塞栓症 (VTE). 大规模输血和脊髓损伤是关键的VTE预测因素,指导未来的双重超声协议.
科学领域:
- 创伤外科 手术 创伤外科
- 血管外科 血管外科
- 关键护理医学 关键护理医学
背景情况:
- 静脉血栓塞栓症 (VTE) 是受伤患者的重大风险.
- 目前的风险评估工具可能无法完全捕捉该人群中的VTE风险.
- 优化VTE监测协议对于患者的治疗结果至关重要.
研究的目的:
- 评估风险评估概况 (RAP) 评分在预测创伤住院患者的静脉动脉损伤方面的有用性.
- 在受伤患者中确定独立的静脉瘤风险因素.
- 为制定针对性的双重超声波 (DUS) 监控协议提供信息.
主要方法:
- 来自创伤住院患者的前性数据的二次分析 (2017年3月至2019年9月).
- 收录标准:入学RAP得分≥5.5以上.
- 统计分析包括回归和ROC分析,以评估VTE可预测性和确定风险因素.
主要成果:
- 分析了1989名患者;8.2%的人经历了静脉动脉突发症 (163名患者).
- 大规模输血 (OR 5.97) 和脊髓损伤 (OR 2.43) 是最强的静脉瘤预测因素.
- 该RAP得分显示VTE可预测性中等 (AUC为0.61).
结论:
- 在预测受伤患者的VTE方面,RAP得分的表现是中等的.
- 确定VTE预测因素可以指导开发一种新的DUS监测策略.
- 需要进一步的导出和验证研究来完善VTE风险分层和监测.
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