危险因素和深静脉血栓形成的Nomogram模型在血症的重症患者:一个回顾性分析
1Department of Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, 610041, China.
Scientific reports
|May 13, 2025
概括
这项研究确定了重症性败血症患者深静脉血栓症 (DVT) 的关键风险因素,包括晚年和血管活性药物使用. 身体预防在这个易受伤害的人群中成为了对DVT的保护因素.
科学领域:
- 关键护理医学 关键护理医学
- 血管医学 血管医学
- 传染性疾病 传染性疾病
背景情况:
- 败血症是深静脉血栓症 (DVT) 的已知危险因素.
- 有限的研究存在于DVT风险因素,特别是在重症败血症患者.
- 目前没有专门的评估工具来评估这个人群中的DVT风险.
研究的目的:
- 确定患有败血症的重症患者深静脉血栓形成的独立风险因素.
- 在这个特定的患者群体中开发一个简单的诺米克图来评估DVT风险.
- 评估物理预防作为对DVT的保护措施的有效性.
主要方法:
- 追溯观察性研究包括1057名进入ICU的败血症患者.
- 排除标准:先前存在的DVT,癌症,创伤,怀孕,重大手术,长期使用葡萄糖皮质激素.
- 用多变量后勤回归和接收器操作特征 (ROC) 曲线来识别风险因素并开发一个名ogram.
主要成果:
- 严重内脏病的独立风险因素包括晚年 (≥48岁),长期使用血管活性药物 (≥336小时),低PaO2/FiO2 (≤275),呼吸道感染,D-二次数升高 (≥3.6),纤维素素减少 (≤3.9).
- 身体预防被确定为对DVT的独立保护因素 (OR=0.51).
- 在DVT和非DVT组之间,在中央静脉导管插入,SOFA得分,机械通风持续时间或住院时间方面没有发现显著差异.
结论:
- 晚年,长期使用血管活性药物,低氧化,呼吸道感染,D-二次数升高和纤维素素降低是严重病情严重的败血症患者中DVT的重要独立风险因素.
- 物理预防在这个人群中显示出对DVT的保护作用.
- 这项研究强调了在重症败血症患者中需要针对性DVT风险评估和预防策略的需要.
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