Risk factors and early warning model of coagulation with extracorporeal circulation device in uremic patients with CRRT
10.3969/j.issn.1673-9701.2025.01.010
- VernacularTitle:尿毒症患者应用CRRT时体外循环装置凝血的危险因素及预警模型
- Author:
Yuan SUN
1
;
Yunyu GU
1
;
Yan HUANG
1
Author Information
1. 南昌大学第二附属医院肾脏内科,江西 南昌 330006
- Publication Type:Journal Article
- Keywords:
Continuous renal replacement therapy;
Uremia;
Coagulation;
Risk factor;
Risk early warning model
- From:
China Modern Doctor
2025;63(1):38-42
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the risk factors of coagulation with extracorporeal circulation device in uremic patients with continuous renal replacement therapy(CRRT),and establish and verify the risk warning model.Methods A total of 210 uremic patients who received CRRT treatment in the Second Affiliated Hospital of Nanchang University from March 2020 to March 2022 were retrospectively selected as training set,and divided into coagulation group and non-coagulation group according to whether coagulation occurred during CRRT treatment.At the same time,90 uremic patients who underwent CRRT treatment in our hospital from April 2022 to April 2023 were selected as validation set according to the ratio of 7:3.Univariate analysis and multivariate Logistic regression were used to analyze the factors related to coagulation with extracorporeal circulation device in uremic patients with CRRT,and a risk prediction model was constructed.The receiver operating characteristic(ROC)curve was used to verify the prediction efficiency of the model.Results In training set,53 patients had coagulation with extracorporeal circulation device,the incidence was 25.24%.Multivariate Logistic regression analysis showed that age≥60 years old,agitation,decreased blood flow,elevated platelet count,and elevated transmembrane pressure were all risk factors for coagulation in patients with uremia treated with CRRT(P<0.05).The Hosmer-Lemeshow test results of the training set showed that the model had a good goodness of fitting,and area under the curve(AUC)of the model was 0.956(95%CI:0.926-0.985,P<0.05)when CRRT was applied to uremic patients,and the sensitivity was 86.40%,the specificity was 83.80%.The goodness of fitting of the validation set was good.The AUC of the prediction model was 0.946(95%CI:0.915-0.977,P<0.05),the sensitivity was 82.60%,and the specificity was 81.80%.Conclusion The risk early warning model based on the above risk factors has a good prediction effect,and can provide a reference for clinical identification of the occurrence of coagulation with extracorporeal circulation device in uremic patients with CRRT.
