The Study Of Predictive Value Of Three Kinds Of Risk Assessment Tables Of Thrombosis In Major Surgery Patients With Deep Venous Thrombosis During Orthopedics

ObjectiveTo compare the predictive performance of three kinds of thrombosis risk assessment scale for deep venous thrombosis among the major orthopedic surgery patients Through a retrospective case control study,selecting a suitable risk assessment tool for the major surgery in department of orthopedics,and providing reference for the department of orthopedics medical staff to screen out the suitable assessment tool for deep venous thrombosis.MethodA retrospective case-control study was used,185 cases of surgical patients were selected from June 2014 to December in the Department of orthopedics of the general hospital in Chongqing,the general data were collected for all patients,and all patients were assessed with three kinds of Wells,Caprini,Autar thrombosis risk assessment table,recording the results,diagnosed DVT patients as DVT group with Doppler ultrasound diagnostic standard,the rest of the patients as the non-DVT group,then drawing receiver operating characteristic,the sensitivity,the specificity and the area under the curve as the index to evaluate predictive value of three risk assessment scales.Result185 cases were included According to the inclusion and exclusion criteria,48 cases had DVT,the incidence was 25.9%,2 patients had pulmonary embolism.ROC curve area under of the three tables of Wells,Caprini,Autar are 0.958,0.680,0.723,respectively,were statistically significant(P<0.05),which showed three kinds of thrombosis risk assessment table happens has a certain predictive ability of DVT among the patients of department of orthopedics,the difference between Wells assessment of the area under the ROC curve with the other two was statistically significant(P<0.05),the difference was not statistically significant between Autar scale and Caprini scale(P>0.05),indicating that the accuracy of Wells prediction is more higher.Wells scale’s cut-off point was 1.5,the corresponding sensitivity was 0.958,specificity was 0.898;Caprini assessment table’s cut-off points was 9.5 points,the sensitivity and specificity were 0.625 and 0.693;Autar evaluation scale boundary value point is 14.5,the sensitivity and the specificity were 0.875,0.518,respectively.ConclusionThe incidence of DVT was higher in the Department of orthopedics after major surgery.Three kinds of thrombotic risk assessment scale had a certain predictive ability of DVT patients in Department of orthopedics operation.The predictive value of wells assessment table is more higher,but it is more suitable for auxiliary clinical doctors to diagnosis and differential diagnosis in patients with DVT.Caprini assessment and Autar assessment scale for DVT patients is more concerned about the risk factors of DVT,which is advantage for the medical staff timely to detect risk factors of DVT,due to the Caprini assessment involved in laboratory projects,if there were missed,it may cause the assessment is not complete,and Autar assessment items in the questionnaire are easy to obtain,and including risk grading and prevention guidelines,therefore more suitable for the orthopedics nursing to use.