多中心内科住院病人静脉血栓栓塞风险评估模型的外部验证

IF 2.3 4区 医学 Q2 HEMATOLOGY
Xiaolan Chen, Hongning Shi, Jiaqi Chang, Wenjia Guo, Yuanhua Yang, Yong Wang, Lei Pan
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引用次数: 0

摘要

在多中心内科住院患者中对静脉血栓栓塞症(VTE)风险评估模型(RAM)进行外部验证。我们前瞻性地收集了2022年1月至2022年12月期间北京世纪坛医院、北京朝阳医院和北京清华长庚医院呼吸科的595名内科患者(310名VTE患者,285名非VTE患者)进行多中心外部验证。比较了 Caprini RAM、Padua RAM、静脉血栓栓塞国际医疗预防登记(IMPROVE)RAM 和石景山(SJT)RAM 的预测能力。本研究共纳入 595 名内科住院患者,其中呼吸科 242 人(40.67%)、呼吸科重症监护室 17 人(2.86%)、神经内科 49 人(8.24%)、重症监护室 34 人(5.71%)、老年病科 26 人(4.37%)、急诊科 22 人(3.70%)、肾内科 71 人(11.93%)、心内科 63 例(10.59%)、血液科 24 例(4.03%)、中医科 6 例(1.01%)、风湿科 9 例(1.51%)、内分泌科 7 例(1.18%)、肿瘤科 14 例(2.35%)、消化科 11 例(1.85%)。多变量逻辑回归分析显示,在内科住院患者中,年龄 60 岁、心力衰竭、肾病综合征、肿瘤、VTE 病史、D-二聚体升高与 VTE 的发生显著相关(P < .05)。VTE 的发生率随 D-二聚体的升高而增加。研究发现,SJT RAM(AUC = 0.80 ± 0.03)的有效性优于 Caprini RAM(AUC = 0.74 ± 0.03)、Padua RAM(AUC = 0.72 ± 0.03)和 IMPROVE RAM(AUC = 0.52 ± 0.03)(P < .05)。SJT RAM的灵敏度和Yoden指数高于Caprini RAM、Pauda RAM和IMPROVE RAM(P < .05),但4种模型的特异性无显著差异(P > .05)。从中国普通住院患者中得出的 SJT RAM 对有 VTE 风险的内科住院患者具有有效和更好的预测能力。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
External Validation of the Risk Assessment Model of Venous Thromboembolism in Multicenter Internal Medicine Inpatients
To external validate the risk assessment model (RAM) of venous thromboembolism (VTE) in multicenter internal medicine inpatients. We prospectively collected 595 internal medical patients (310 with VTE patients, 285 non-VTE patients) were from Beijing Shijitan Hospital, Beijing Chaoyang Hospital, and the respiratory department of Beijing Tsinghua Changgeng Hospital from January 2022 to December 2022 for multicenter external validation. The prediction ability of Caprini RAM, Padua RAM, The International Medical Prevention Registry on Venous Thromboembolism (IMPROVE) RAM, and Shijitan (SJT) RAM were compared. This study included a total of 595 internal medicine inpatients, including 242 (40.67%) in the respiratory department, 17 (2.86%) in the respiratory intensive care unit, 49 (8.24%) in the neurology department, 34 (5.71%) in the intensive care unit, 26 (4.37%) in the geriatric department, 22 (3.70%) in the emergency department, 71 (11.93%) in the nephrology department, 63 (10.59%) in the cardiology department, 24 (4.03%) in the hematology department, 6 (1.01%) in the traditional Chinese medicine department, 9 (1.51%) cases in the rheumatology department, 7 (1.18%) in the endocrinology department, 14 (2.35%) in the oncology department, and 11 (1.85%) in the gastroenterology department. Multivariate logistic regression analysis showed that among internal medicine inpatients, age > 60 years old, heart failure, nephrotic syndrome, tumors, history of VTE, and elevated D-dimer were significantly correlated with the occurrence of VTE ( P < .05). The incidence of VTE increases with the increase of D-dimer. It was found that the effectiveness of SJT RAM (AUC = 0.80 ± 0.03) was better than Caprini RAM (AUC = 0.74 ± 0.03), Padua RAM (AUC = 0.72 ± 0.03) and IMPROVE RAM (AUC = 0.52 ± 0.03) ( P < .05). The sensitivity and Yoden index of SJT RAM were higher than those of Caprini RAM, Pauda RAM, and IMPROVE RAM ( P < .05), but specificity was not significantly different between the 4 models ( P > .05). The SJT RAM derived from general hospitalized Chinese patients has effective and better predictive ability for internal medicine inpatients at risk of VTE.
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来源期刊
CiteScore
4.40
自引率
3.40%
发文量
150
审稿时长
2 months
期刊介绍: CATH is a peer-reviewed bi-monthly journal that addresses the practical clinical and laboratory issues involved in managing bleeding and clotting disorders, especially those related to thrombosis, hemostasis, and vascular disorders. CATH covers clinical trials, studies on etiology, pathophysiology, diagnosis and treatment of thrombohemorrhagic disorders.
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