| Objectives The aim of this study was to study the value and differences in adopting the Caprini and Padua risk assessment models predict the occurrence of venous thromboembolism(VTE)in the inpatients admitted to medical wards and provide the basis for formulating the VTE risk assessment model in China.Methods A total of 552 patients in the medical department of the North China University of Science and Technology Affiliated Hospital,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences and Tangshan Gongren Hospital were enrolled from February 17,2016 to May 17,2016 who met the criteria in this retrospective case-control study.184 inpatients with VTE and 368 inpatients who were extracted randomly according to 1:2 principle during the same period without VTE were admitted to the North China University of Science and Technology Affiliated Hospital,Peking Union Medical College Hospital and Tangshan Gongren Hospital.The patients were respectively stratified into groups based on the Caprini risk assessment model and Padua risk assessment model.The association between the risk factors and VTE were analyzed with multivariate logistic regression analysis model.The difference of the incidence of VTE among different groups stratified by the Caprini risk assessment model and the Padua risk assessment model were compared.Receiver operating characteristic curve(ROC)were used to calculate the area under the curve(AUC)and compare the value of the two risk assessment models of VTE risk in inpatients.Results The average Caprini risk scores in the patients with VTE were significant higher than that of the patients without VTE(7.29±2.43 vs 4.34±2.50,t=-13.308,P<0.001).According to the Caprini risk assessment model,the higher the scores were,the the higher the incidence of VTE was(P<0.001).Moreover,the risk of developing VTE in patients with super-high risk was 18.675 times than that of patients who weren't the super-high risk(95% CI: 10.417~33.478).The average Padua risk scores in patients with VTE were significant higher than that of patients without VTE(4.22±2.06 vs 2.49±2.16,t=-9.173,P<0.001).Furthermore,the higher the total scores of Padua risk assessment model were,the higher the incidence of VTE was(P<0.001).The risk of VTE in high-risk patients was 3.442 times than that of those with low-risk(95% CI: 2.379~4.979).In logistic regression analysis,we found that elderly patients(?70yr),Body Mass Index(BMI)>25 kg/m2,leg swelling,suffering from malignancy,recent stroke(<1 month),serious lung disease,history of DVT/PE,central venous access,confined to bed(>3days)were the independent risk factors of inpatients with VTE.The most dangerous risk factors of VTE were history of DVT/PE(OR=7.231),the second one was recent stroke(<1 month)(OR=6.643).The area under the curve(AUC)(0.817)of Caprini risk assessment model predicted in hospitalized patients with VTE was higher than that of Padua risk assessment model predicted inpatients with VTE(0.721)(Z = 4.954,P <0.001).In this study,25.36% of in patients was received VTE prophylaxis in the hospital,17.39% of them received mechanical prophylaxis,12.68% received pharmacological methods and 4.71% received both.The proportion of patients with VTE in hospital who received the preventive measures was significantly lower than that without VTE,and the difference was statistically significant(16.30% vs 29.89%,P <0.001).Conclusions 1 The Caprini risk assessment model and Padua risk assessment model can predict the risk of VTE in the inpatients admitted to medical wards.2 The predictive value of the Caprini risk assessment model was superior to the Padua risk assessment model in inpatients and can be revised on the basis of the Caprini risk assessment model.3 Clinical doctors should pay attention to take thromboembolic prophylactic treatment in high-risk medical VTE patients during the clinical treatment. |
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