临床评分量表对预警院内深静脉血栓形成防治体系的临床价值

目的 比较改良Caprini评分量表与Autar评分量表对DVT的预警价值.方法 以影像学为标准,对84例已确诊DVT患者进行回顾性分析,比较改良Caprini评分量表与Autar评分量表对院内DVT的预警价值,利用秩和检验了解两量表的实用性及高危识别效能,并应用两量表对5个临床科室的425例住院患者进行前瞻性研究,通...

The clinical value of the clinical scoring scale in early warning system for prevention and treatment of deep venous thrombosis

Objective Compare the diagnostic value of modified Caprini rating scale and Autar scale.Methods Using imaging as gold standard,84 cases which have been confirmed in patients with DVT were analyzed retrospectively,and compared the values in the diagnosis of deep venous thrombosis by using Autar scale and modified Caprini scale.Also we used the practicability of using rank and inspection to understand high risk identification efficiency of the two scales.A prospective study was conducted on 425 patients from 5 clinical departments by using the two scales,and the clinical application value on predicting nosocomial DVT was compared by the area under the ROC curve.Results 1.In the retrospective analysis,the statistics of Autar rating scale and the modified Caprini rating scale were conducted by rank sum test,Z=-7.721,P=0.000<0.05,which indicated significant differences between the two scales.The effective rates of the AUTOAR Autar scale and the modified Caprini scale were 33.3%(28/84)vs 92.9%(78/84),respectively,indicating that the latter had a higher accuracy in predicting DVT.2.The highest scoring risk factors in the two score scales were similar,followed by bed rest,advanced age,malignant tumor,and cardiovascular and cerebrovascular disease,suggesting that patients with the above risk factors should be paid close attention to the occurrence of VTE.3.In prospective analysis of the results of 425 patients with two scales,the AUC values of AUTOAR and the modified Caprini scale were 0.628 and 0.684,respectively.In addition,the incidence of DVT in the Autar and the modified Caprini scale was 4.68%(11/235)and 0%(0/63),respectively,suggesting that the improved Caprini scale had a higher warning effect on DVT.Conclusions 1.Compared with the Autar scale,Modified Caprini scale showed higher accuracy and low missed diagnosis rate in early warning of DVT.2.Bed rest,advanced age,,malignant tumor,and cardiovascular and cerebrovascular disease are significant risk factors for predicting DVT.3.The two scoring scales still have some limitations in the early identification of VTE,and the diagnostic efficiency of VTE should be further improved by combining clinical dynamic scoring and laboratory monitoring.