卡普里尼评分的演变

K. Lobastov, A. V. Kovalchuk, I. Schastlivtsev, L. Laberko
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摘要

这篇文章对文献进行了叙述性回顾,探讨了使用卡普里尼评分对医院获得性 VTE 进行个体风险评估的问题。文章提供了现代流行病学数据,证实了医院静脉血栓问题在医学和社会方面的重要意义。文中讨论了卡普里尼评分自 1991 年发布初始版本以来的自然演变问题,对 2005 年、2010 年和 2013 年的修订版本进行了比较分析,并讨论了证明 2005 年经典版本优越性的验证研究的特点。还关注了将卡普里尼评分纳入医疗文件的问题,以及风险评估和指定预防措施过程的自动化问题。另外还讨论了根据评估分数将患者划分为 VTE 风险组的方法的异质性问题;现代研究数据证实存在极高(9-10 分)和极高(≥11 分)风险组,需要采取个性化方法预防血栓并发症。在对 68 项验证研究进行荟萃分析的基础上,提供了根据 Caprini 评分对不同体质的患者进行 VTE 登记的频率汇总数据。讨论了在卡普里尼评分的基础上使用以患者为导向的问卷的可能性,这些问卷与原始量表具有很高的一致性,但尚未在前瞻性研究中进行过研究。提出了使用 2005 版 Caprini 评分单独评估 VTE 风险的修订算法,并开出了适当的预防处方。结论是,卡普里尼评分仍在根据医学和医疗保健发展的总体趋势不断改进和发展,同时保持着医院获得性 VTE 风险个体评估系统研究最多、需求最大的地位。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The evolution of the Caprini score
The article is a narrative review of the literature that addresses the issues of individual risk assessment of hospital-acquired VTE using the Caprini score. It provides modern epidemiological data confirming the high medical and social significance of the problem of hospital venous thrombosis. The questions of the natural evolution of the Caprini score since the publication of the initial version in 1991 are discussed, a comparative analysis of the modifications of 2005, 2010 and 2013 is carried out, and the features of validation studies that have proven the superiority of the classical version of 2005 are discussed. Attention is paid to the problem of integrating the Caprini score into medical documentation with automation of the process of risk assessment and the appointment of preventive measures. The issue of heterogeneity of approaches to dividing patients into risk groups for developing VTE in accordance with the assessed scores is discussed separately; data from modern studies are presented confirming the existence of very high (9–10 points) and extremely high (≥11 points) risk groups that require an individual approach to prevention of thrombotic complications. Summary data are provided on the frequency of registration of VTE in accordance with Caprini scores in patients of various medical profiles based on a meta-analysis of 68 validation studies. The possibility of using patient-oriented questionnaires based on the Caprini score is discussed, which demonstrate high consistency with the original scale, but have not yet been studied in prospective studies. Revised algorithms are proposed to individually assess the risk of VTE using the 2005 vers of the Caprini score and prescribe adequate prophylaxis. It is concluded that the Caprini score still continues to improve and evolve in accordance with general trends in the development of medicine and healthcare, while maintaining the status of the most studied and in demand system for individual assessment of the risk of developing hospital-acquired VTE.
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