Analysis Of The Risk Factors For Venous Thrombosis After Neurosurgery In Caprini Model

Objectives To analyze the risk factors of venous thromboembolism(VTE)in patients after neurosurgery,to evaluate the effectiveness of Caprini model in predicting the risk of VTE in patients after neurosurgery,and to provide clinical and theoretical basis for the prevention of VTE in patients after neurosurgery.Methods Based on the principle of case-control design,432 consecutive neurosurgical patients hospitalized in the Affiliated Hospital of North China University of Technology and Tangshan Workers’Hospital from June 2012 to June 2017 were selected,of which 144patients with VTE after neurosurgery were in the VTE group.288 neurosurgical patients admitted at the same time were randomly selected.No VTE occurred in the non-VTE group.The clinical data of patients were collected and the correlation between VTE and VTE was analyzed.Multivariate logistic regression was used to analyze the risk factors of VTE in neurosurgery patients,and the relative risk(OR)and 95%confidence interval(CI)were calculated.According to the Caprini model,the risk of VTE was scored and graded.The predictive value of the Caprini model for VTE high-risk population after neurosurgery was evaluated by using the area under the curve(AUC)of the Receiver Operating Characteristic Curve(ROC).Results 1 There were significant differences in clinical data age,body mass index(BMI),Glasgow Coma Scale(GCS)and BMI(>25kg/m~2)between VTE group and non-VTE group(P<0.05).2 It was found that hospitalized patients with hypertension and/or history of coronary heart disease had a higher risk of VTE(P<0.05).3 In laboratory examination,patients with high C-reactive protein(CRP)value were more likely to develop VTE,and patients with high D-dimer index were more likely to develop VTE(P<0.05).4 VTE was more likely to occur in neurosurgical inpatients with operation time(>3 hours)and ASA classification(III-IV)(P<0.05).5 Multivariate logistic regression analysis showed that long operation time(>3 hours),pulmonary diseases(including pneumonia),bedridden(>72hours),BMI(>25kg/m~2),ASA grade III-IV,combined with coronary heart disease and/or hypertension,elevated CRP and elevated D-dimer were the high risk factors for VTE after neurosurgery.6 According to the Caprini model,the score and risk stratification of hospitalized patients who met the research criteria showed that the score of Caprini in VTE group(10.236±2.868)was significantly higher than that in non-VTE group(7.059±2.641)(P<0.001).According to the rating standard of Caprini risk assessment model,the higher the risk level,the higher the incidence of VTE(P<0.05).The AUC of Caprini risk assessment model for predicting VTE in patients after neurosurgery was 0.799(P<0.001).Conclusions 1 The risk and duration of VTE(>3 hours),pulmonary diseases(including pneumonia),bedridden(>72 hours),BMI(>25kg/m2),ASA(III-IV),coronary heart disease and/or hypertension,CRP elevation and D-dimer elevation are the high risk factors for VTE in patients after neurosurgery.The hospitalized patients with the above factors should be alert to the risk of VTE and take early precautions against the high-risk population.2Caprini model can predict the risk of VTE in patients after neurosurgery.Figure 1;Table 14;Reference 158...