Clinical Value Analysis Of Caprini Thrombosis Risk Assessment Scale For VTE Classification Diagnosis

Objectives:In recent years,the incidence and mortality of venous thromboembolism(VTE)have increased year by year,and its incidence is concealed.It is often difficult to find at the beginning of the disease,and the symptoms lack specificity,which is easy to miss diagnosis and misdiagnosis.VTE diagnosis mainly depends on imaging examination.Pulmonary angiography is the gold standard of PTE(pulmonary thromboembolism),but it is not adopted by patients and medical staff because of its invasiveness;non-invasive examinations such as vascular ultrasound and CTPA are expensive,asthromboembolic Disease diagnosis methods often cause waste of medical resources;the Chinese Medical Association 2018 embolization prevention guidelines recommend the Caprini Thrombosis Risk Assessment Scale for VTE risk assessment of surgical patients,using the Padua Thrombosis Risk Assessment Scale(Padua Thrombosis Risk Assessment Scale)Quantify thrombosis risk assessment for medical patients to prevent and diagnose early.However,in recent years,some studies have shown that the Caprini Thrombosis Risk Assessment Scale is equally applicable to medical inpatients and is more effective than the Padua Thrombosis Risk Assessment Scale.Whether the Caprini Thrombosis Risk Score can be used to predict risk stratification,and the diagnostic value of VTE classification is not yet clear.Therefore,this study used the clinical data collection and statistical analysis of VTE patients in our hospital to explore the VTE epidemiology in this area,screening the thrombus risk assessment model more suitable for hospitalized patients in general hospitals,and the classification value of thrombosis risk scores for venous thromboembolic diseases.And the risk factors of VTE;improve the prevention,diagnosis and treatment of high-risk patients with VT in this area,improve the quality of medical care,and ensure medical safety.Materials and methods:VTE group:retrospectively collected clinical data of our hospital diagnosed as VTE(including PTE,DVT(deep vein thrombosis),PTE combined with DVT)from January 1,2017 to December 31,2017.PTE was diagnosed by CTPA(CT pulmonary angiography)or MRPA(magnetic resonance pulmonary angiography).Patients with incomplete hospitalization,superficial venous thrombosis,anticoagulant therapy or physical precautions before hospitalization were excluded.A total of 335 patients in the VTE group were selected.Control group:Randomized digital table method was used to randomly select the inpatient data of the same department in the same period as the VTE group at a ratio of 3:1.The inclusion criteria were no diagnosis of PTE,DVT,DVT and PTE in the discharge diagnosis.Exclude incomplete hospitalization data.Finally,108 patients in the control group were enrolled.A retrospective case-control study of this study.The epidemiological study of VTE in our hospital was collected by collecting the inpatient data of the VTE group and the control group and entering the Excel form.The Caprini thrombus risk assessment model and the Padua thrombus risk assessment model were scored for all patients,and the logistic regression analysis was used to select more suitable.The thrombus assessment model of hospitalized patients in general hospitals;and the ROC curve and the calculation of the Yoden index were used to obtain the optimal threshold values for the control group,PTE group,DVT group,DVT and PTE group,then the group’s classification diagnosis was initially predicted;multivariate regression analysis was used to screen the common risk factors in the region for risk factors in the thrombus risk assessment model more suitable for general hospitals.Results:From January 2017 to December 2017,the number of discharged patients in our hospital was 108015,and 335 patients with VTE were diagnosed,including 47 patients with PTE(14.03%),183 patients with DVT(54.63%),and 105 with PTE and DVT.Example(31.34%).The prevalence of VTE was about 3.1‰,of which the prevalence of PTE was 0.4‰,the prevalence of DVT was 1.7‰,and the clinical stage of DVT with PTE was 0.97‰.There were 165 male patients(49.25%)and 170 females(50.75%)with an average age of 59.47±16.58 years.The incidence of VTE is spread throughout almost all departments of our hospital,including vascular surgery,respiratory,cardiology,and orthopedics.Compared with the Padua score table,the Caprini model had a higher correlation with VTE(Padua score OR value 1.403,Caprini score OR value 1.972),the difference was statistically significant(P<0.05),so the Caprini model is more suitable for general hospital patients.Predictive value of Caprini score for diagnosis of PTE,DVT,PTE combined with DVT:The optimal cut-off value of Caprini score in VTE group and control group was 3.5,the difference was statistically significant(P<0.05);The optimal cutoff value of Caprini score in the PTE group,DVT group,PTE combined with DVT group and control group were 3.5,the difference was statistically significant(P<0.05).the optimal threshold value of PTE group and DVT group was 4.5,the difference was statistically significant(P<0.05).The optimal cut-off value of PTE group and PTE combined with DVT group was 4.5,the difference was statistically significant(P<0.05).The optimal threshold value of DVT group and PTE combined with DVT group was 6.5,the difference was statistically significant(P<0.05).In summary,Caprini score>3.5 VTE has a higher diagnostic risk,3.5 to 4.5 PTE has a higher diagnostic risk;4.5 to 6.5 DVT has a higher diagnostic risk;>6.5 PTE combined with DVT has a higher risk of diagnosis.Conclusions:The incidence of VTE in general hospitals is relatively high,involving various departments of our hospital,mainly in vascular surgery,respiratory,cardiology,or orthopedics.Compared with the Padua score sheet,the Caprini model is more suitable for screening high-risk patients with VTE in general hospitals;and the main risk factors for hospitalized patients include age,BMI,lower extremity edema,varicose veins,large open surgery,long-term bed rest,malignant tumor,and VTE history.In addition,the Caprini score has a classification predictive value for the diagnosis of PTE,DVT,and PTE combined with DVT.