{"title":"来自如皋的一项横断面研究:帕多瓦和卡普里尼评分预测老年人静脉血栓栓塞风险的比较分析","authors":"Jiayan Lu, Xiaoping Han, Jinhua Xu, Qixia Guo, Jianhua Wang, Jianming Xie, Shanzhong Cheng, Songshi Ni","doi":"10.1111/anec.70107","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Objective</h3>\n \n <p>To evaluate and compare the predictive performance of Padua and Caprini scores for venous thromboembolism (VTE) risk assessment in individuals aged ≥ 90 years.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>A cross-sectional study was conducted among 511 nonagenarians in Rugao, China. Participants underwent comprehensive clinical assessments including both Padua and Caprini risk scoring. VTE events were monitored through the follow-up period. The predictive efficacy of both scoring systems was analyzed using receiver operating characteristic (ROC) curves, and risk factors were evaluated through multivariate logistic regression.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>During follow-up, 31 participants (6.07%) developed VTE. The VTE group demonstrated significantly higher mean Padua scores (4.97 ± 2.21 vs. 4.11 ± 2.45, <i>p</i> = 0.0463), Caprini scores (6.39 ± 2.42 vs. 5.02 ± 2.39, <i>p</i> = 0.0044), and D-dimer levels (median 2.79 vs. 1.31 mg/L, <i>p</i> = 0.0133) compared to the non-VTE group. Both scoring systems showed moderate predictive capability, with the Padua score achieving an area under the curve (AUC) of 0.625 (95% CI: 0.533–0.717) and the Caprini score showing an AUC of 0.679 (95% CI: 0.590–0.768). Optimal cutoff values were 3.5 points for the Padua score (sensitivity 80.65%, specificity 50.42%) and 4.5 points for the Caprini score (sensitivity 77.42%, specificity 51.46%). Multivariate analysis identified atrial fibrillation (OR 4.130, 95% CI: 1.667–9.673, <i>p</i> = 0.001) and elevated Caprini score (OR 1.310, 95% CI: 1.073–1.582, <i>p</i> = 0.006) as significant independent risk factors for VTE. Interestingly, hypertension showed an unexpected protective association with VTE risk (OR 0.400, 95% CI: 0.162–0.907, <i>p</i> = 0.035).</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>While both Padua and Caprini scores demonstrate moderate predictive value for VTE risk in nonagenarians, their accuracy suggests the need for age-specific refinement.</p>\n </section>\n </div>","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"30 5","pages":""},"PeriodicalIF":1.1000,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/anec.70107","citationCount":"0","resultStr":"{\"title\":\"Comparative Analysis of Padua and Caprini Scores in Predicting Venous Thromboembolism Risk Among Nonagenarians: A Cross-Sectional Study From Rugao\",\"authors\":\"Jiayan Lu, Xiaoping Han, Jinhua Xu, Qixia Guo, Jianhua Wang, Jianming Xie, Shanzhong Cheng, Songshi Ni\",\"doi\":\"10.1111/anec.70107\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Objective</h3>\\n \\n <p>To evaluate and compare the predictive performance of Padua and Caprini scores for venous thromboembolism (VTE) risk assessment in individuals aged ≥ 90 years.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>A cross-sectional study was conducted among 511 nonagenarians in Rugao, China. Participants underwent comprehensive clinical assessments including both Padua and Caprini risk scoring. VTE events were monitored through the follow-up period. The predictive efficacy of both scoring systems was analyzed using receiver operating characteristic (ROC) curves, and risk factors were evaluated through multivariate logistic regression.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>During follow-up, 31 participants (6.07%) developed VTE. The VTE group demonstrated significantly higher mean Padua scores (4.97 ± 2.21 vs. 4.11 ± 2.45, <i>p</i> = 0.0463), Caprini scores (6.39 ± 2.42 vs. 5.02 ± 2.39, <i>p</i> = 0.0044), and D-dimer levels (median 2.79 vs. 1.31 mg/L, <i>p</i> = 0.0133) compared to the non-VTE group. Both scoring systems showed moderate predictive capability, with the Padua score achieving an area under the curve (AUC) of 0.625 (95% CI: 0.533–0.717) and the Caprini score showing an AUC of 0.679 (95% CI: 0.590–0.768). Optimal cutoff values were 3.5 points for the Padua score (sensitivity 80.65%, specificity 50.42%) and 4.5 points for the Caprini score (sensitivity 77.42%, specificity 51.46%). Multivariate analysis identified atrial fibrillation (OR 4.130, 95% CI: 1.667–9.673, <i>p</i> = 0.001) and elevated Caprini score (OR 1.310, 95% CI: 1.073–1.582, <i>p</i> = 0.006) as significant independent risk factors for VTE. Interestingly, hypertension showed an unexpected protective association with VTE risk (OR 0.400, 95% CI: 0.162–0.907, <i>p</i> = 0.035).</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusions</h3>\\n \\n <p>While both Padua and Caprini scores demonstrate moderate predictive value for VTE risk in nonagenarians, their accuracy suggests the need for age-specific refinement.</p>\\n </section>\\n </div>\",\"PeriodicalId\":8074,\"journal\":{\"name\":\"Annals of Noninvasive Electrocardiology\",\"volume\":\"30 5\",\"pages\":\"\"},\"PeriodicalIF\":1.1000,\"publicationDate\":\"2025-08-20\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://onlinelibrary.wiley.com/doi/epdf/10.1111/anec.70107\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Annals of Noninvasive Electrocardiology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1111/anec.70107\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Annals of Noninvasive Electrocardiology","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/anec.70107","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0
摘要
目的评价和比较Padua评分和capriti评分在≥90岁人群静脉血栓栓塞(VTE)风险评估中的预测效果。方法对如皋市511名老年人进行横断面调查。参与者接受了全面的临床评估,包括帕多瓦和卡普里尼风险评分。在随访期间监测静脉血栓栓塞事件。采用受试者工作特征(ROC)曲线分析两种评分系统的预测效果,采用多因素logistic回归评价两种评分系统的危险因素。结果随访期间,31例(6.07%)发生静脉血栓栓塞。与非VTE组相比,VTE组的平均Padua评分(4.97±2.21比4.11±2.45,p = 0.0463)、Caprini评分(6.39±2.42比5.02±2.39,p = 0.0044)和d -二聚体水平(中位数2.79比1.31 mg/L, p = 0.0133)均显著高于VTE组。两种评分系统均表现出中等的预测能力,Padua评分的曲线下面积(AUC)为0.625 (95% CI: 0.533-0.717), Caprini评分的AUC为0.679 (95% CI: 0.590-0.768)。Padua评分的最佳截止值为3.5分(敏感性80.65%,特异性50.42%),Caprini评分的最佳截止值为4.5分(敏感性77.42%,特异性51.46%)。多因素分析发现房颤(OR 4.130, 95% CI: 1.667-9.673, p = 0.001)和capriti评分升高(OR 1.310, 95% CI: 1.073-1.582, p = 0.006)是静脉血栓栓塞的重要独立危险因素。有趣的是,高血压显示出意想不到的与静脉血栓栓塞风险的保护性关联(OR 0.400, 95% CI: 0.162-0.907, p = 0.035)。结论:尽管Padua和capriti评分对90多岁老年人静脉血栓栓塞风险的预测价值中等,但其准确性表明需要针对年龄进行细化。
Comparative Analysis of Padua and Caprini Scores in Predicting Venous Thromboembolism Risk Among Nonagenarians: A Cross-Sectional Study From Rugao
Objective
To evaluate and compare the predictive performance of Padua and Caprini scores for venous thromboembolism (VTE) risk assessment in individuals aged ≥ 90 years.
Methods
A cross-sectional study was conducted among 511 nonagenarians in Rugao, China. Participants underwent comprehensive clinical assessments including both Padua and Caprini risk scoring. VTE events were monitored through the follow-up period. The predictive efficacy of both scoring systems was analyzed using receiver operating characteristic (ROC) curves, and risk factors were evaluated through multivariate logistic regression.
Results
During follow-up, 31 participants (6.07%) developed VTE. The VTE group demonstrated significantly higher mean Padua scores (4.97 ± 2.21 vs. 4.11 ± 2.45, p = 0.0463), Caprini scores (6.39 ± 2.42 vs. 5.02 ± 2.39, p = 0.0044), and D-dimer levels (median 2.79 vs. 1.31 mg/L, p = 0.0133) compared to the non-VTE group. Both scoring systems showed moderate predictive capability, with the Padua score achieving an area under the curve (AUC) of 0.625 (95% CI: 0.533–0.717) and the Caprini score showing an AUC of 0.679 (95% CI: 0.590–0.768). Optimal cutoff values were 3.5 points for the Padua score (sensitivity 80.65%, specificity 50.42%) and 4.5 points for the Caprini score (sensitivity 77.42%, specificity 51.46%). Multivariate analysis identified atrial fibrillation (OR 4.130, 95% CI: 1.667–9.673, p = 0.001) and elevated Caprini score (OR 1.310, 95% CI: 1.073–1.582, p = 0.006) as significant independent risk factors for VTE. Interestingly, hypertension showed an unexpected protective association with VTE risk (OR 0.400, 95% CI: 0.162–0.907, p = 0.035).
Conclusions
While both Padua and Caprini scores demonstrate moderate predictive value for VTE risk in nonagenarians, their accuracy suggests the need for age-specific refinement.
期刊介绍:
The ANNALS OF NONINVASIVE ELECTROCARDIOLOGY (A.N.E) is an online only journal that incorporates ongoing advances in the clinical application and technology of traditional and new ECG-based techniques in the diagnosis and treatment of cardiac patients.
ANE is the first journal in an evolving subspecialty that incorporates ongoing advances in the clinical application and technology of traditional and new ECG-based techniques in the diagnosis and treatment of cardiac patients. The publication includes topics related to 12-lead, exercise and high-resolution electrocardiography, arrhythmias, ischemia, repolarization phenomena, heart rate variability, circadian rhythms, bioengineering technology, signal-averaged ECGs, T-wave alternans and automatic external defibrillation.
ANE publishes peer-reviewed articles of interest to clinicians and researchers in the field of noninvasive electrocardiology. Original research, clinical studies, state-of-the-art reviews, case reports, technical notes, and letters to the editors will be published to meet future demands in this field.