在重症患者中预测静脉血栓栓塞的风险 (PROVE-IT):一个模型开发和验证研究
Sean C S Rivrud1, Èmese R H Heijkoop2, Lisa Hulshof3
1Department of Intensive Care, University Medical Center Groningen, Groningen, the Netherlands; Department of Hematology, University Medical Center Groningen, Groningen, the Netherlands.
Journal of thrombosis and haemostasis : JTH
|July 5, 2025
概括
开发了一种新的预后模型,即PROVE-IT,用于预测重症患者的静脉血栓塞栓症 (VTE). 虽然校准得很好,但其可接受的歧视性和不清楚的临床实用性目前限制了其实施.
科学领域:
- 临界护理医学 临界护理医学
- 血管外科 血管外科
- 流行病学 流行病学
背景情况:
- 静脉血栓塞栓症 (VTE) 是重症患者的一个重大并发症.
- 高VTE率可能源于高风险个体的血栓预防失败.
- 一个预后模型可以实现个性化干预,以减少VTE发生率.
研究的目的:
- 开发和外部验证在重症患者中对VTE的预后模型.
- 该模型的名称是预测危急病患者静脉血栓栓塞的风险 (PROVE-IT).
主要方法:
- 住院VTE后重症监护室的入院是主要结果.
- 一个逻辑回归模型使用了14个已确定的VTE预后因素.
- 在独立队列中的外部验证评估了模型性能 (C统计,校准,DCA).
主要成果:
- 在26218名患者中开发了PROVE-IT模型,在1983名患者中得到了验证.
- 内部验证显示C统计值为0.681;外部验证结果为0.629.
- 该模型显示出出色的内部校准和良好的外部校准,但决策曲线分析显示出不清楚的临床效用.
结论:
- 开发和验证了重症患者住院VTE的预后模型.
- 该模型表现出良好的外部校准,但只有可接受的歧视.
- 不清楚的临床实用性阻止了目前临床实施的建议.
相关概念视频
Venous Thrombosis III: Interprofessional Care
26
Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
26
Venous Thrombosis II: Clinical Manifestations and Diagnostic Studies
41
The key difference between Superficial Vein Thrombosis (SVT) and Deep Vein Thrombosis (DVT) lies in their location and severity.Clinical ManifestationsSVT typically presents with localized pain, tenderness, and redness along the course of a superficial vein, often accompanied by a palpable, cord-like structure under the skin. This condition is usually less dangerous than DVT but can be uncomfortable and may lead to complications such as cellulitis or, rarely, a clot extension into the deep...
41
Venous Thrombosis IV: Nursing Management
25
Nursing management begins with a thorough assessment of the patient's health history. Key factors include trauma to veins, peripherally inserted central catheters, varicose veins, recent pregnancy or childbirth, surgery, bacteremia, prolonged bed rest, atrial fibrillation, COPD, heart failure, cancer, coagulation disorders, myocardial infarction, spinal cord injury, stroke, prolonged travel, recent bone fractures, and dehydration. Review medication intake, particularly oral contraceptives,...
25
Venous Thrombosis I: Introduction
45
Venous thrombosis, the most common disorder of the veins, involves the formation of a thrombus or blood clot associated with vein inflammation. It can be classified as either superficial vein thrombosis or deep vein thrombosis.Superficial Vein Thrombosis: This involves the formation of a thrombus in a superficial vein, usually the greater or lesser saphenous vein. Though less severe than deep vein thrombosis (DVT), SVT can lead to complications if untreated.Deep Vein Thrombosis (DVT): This...
45
Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care
46
Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
46
Venous Return
7.2K
The circulatory system plays a crucial role in ensuring the optimal functioning of the human body. One of its critical components is venous return - the process that completes the blood circulation cycle. This article will delve into the concept of venous return, how it works, and its significance to our health.
What is Venous Return?
Venous return refers to the rate at which blood flows back to the heart from the body's peripheral veins. It's an integral part of the circulatory system...
What is Venous Return?
Venous return refers to the rate at which blood flows back to the heart from the body's peripheral veins. It's an integral part of the circulatory system...
7.2K


