外科住院患者静脉血栓栓塞的风险评估模型:多中心回顾性队列研究
Mengying Xie1,2, Zhiliang Zhou1,2, Fan Fei1,3
1Department of General Practice, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, 325027, China.
European journal of medical research
|November 28, 2025
概括
在手术患者的静脉血栓塞栓症 (VTE) 风险评估模型 (RAM) 显示差异差异和临床效用有限. 需要新的策略来准确预测手术护理中的VTE风险.
科学领域:
- 医学研究 医学研究
- 临床流行病学临床流行病学
- 外科手术的结果
背景情况:
- 静脉血栓栓塞 (VTE) 是手术患者发病和死亡的主要原因.
- 准确的VTE风险评估对于指导血栓预防策略至关重要.
- 在手术患者群体中,现有的VTE风险评估模型 (RAMs) 的比较有效性尚未得到充分证实.
研究的目的:
- 评估六种常见的VTERAM在外科住院患者的预测性能.
- 为了比较这些RAM的区分,校准和临床实用性.
主要方法:
- 在四个中心 (2020-2022) 进行回顾性队列研究 (SURG-VTE).
- 评估了卡普里尼,帕多瓦,威尔斯,日内瓦,奥塔尔和IMPROVE的成绩.
- 使用后勤回归,AUC,Brier分数和决策曲线分析评估VTE预测.
主要成果:
- 在4851名外科住院患者中,VTE发生在17.0%的人群中.
- 大多数RAM显示风险组之间存在显著差异,但整体歧视差 (AUC 0.594-0.713).
- 对所有模型来说,正净益处是次优的,质疑临床效用.
结论:
- 目前的RAM在分辨静脉瘤风险,精度和手术患者的校准方面存在局限性.
- 在手术护理中需要改进VTE风险预测策略.
- 与其他模型相比,IMPROVE评分显示了更好的校准.
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