Effectiveness of Caprini risk assessment model in predicting preoperative deep vein thrombosis among patients with hip fractures
10.3760/cma.j.cn115682-20210128-00449
- VernacularTitle:Caprini风险评估模型预测术前髋部骨折患者深静脉血栓形成的有效性
- Author:
Yifeng GUO
1
;
Yufen MA
;
Aimin GUO
;
Yaping CHEN
;
Na GAO
;
Wei HAN
;
Haibo DENG
Author Information
1. 中国医学科学院北京协和医学院 北京协和医院骨科 100730
- Keywords:
Deep venous thrombosis;
Hip fracture;
Caprini risk assessment model
- From:
Chinese Journal of Modern Nursing
2021;27(35):4818-4823
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the effectiveness of Caprini risk assessment model in screening deep vein thrombosis (DVT) formation in patients with preoperative hip fractures.Methods:This study was a retrospective cohort study. From January 2017 to December 2018, a total of 242 patients with hip fractures in the orthopedic trauma ward of Peking Union Medical College Hospital were selected as the research subjects by the convenient sampling method. 46 patients diagnosed with DVT by Doppler ultrasonography of lower extremities before surgery were set as the DVT group, while 196 non-DVT patients were set as the non-DVT group. The risk factors of preoperative DVT in patients with hip fractures screened by Caprini risk assessment model were analyzed by binomial logistic regression, and the optimal risk stratification for preoperative DVT in patients with hip fracture was determined based on Caprini score. ROC curve was used to evaluate the clinical predictive efficacy of Caprini risk assessment model.Results:Caprini score of patients in the DVT group was 11.0 (9.8, 12.0) , which was higher than 9.0 (9.0, 11.0) of patients in the non-DVT group, and the difference was statistically significant ( Z=-4.009, P<0.01) . Binomial logistic regression analysis showed that, past or current history of malignant tumors and venous thromboembolism were the main risk factors for preoperative DVT in patients with hip fractures ( OR=3.162, 31.107; P<0.05) . The preoperative risk of DVT in patients with hip fractures assessed by Caprini risk stratification as extremely high-risk (≥12 points) was 6.017 times that of patients with intermediate-risk (7-9 points) , and the difference was statistically significant ( P< 0.01) . The preoperative risk of DVT in patients with hip fractures rated as high-risk risk grade (10-11 points) was 2.836 times that of patients with intermediate-risk risk grade (7-9 points) , and the difference was statistically significant ( P=0.010) . The optimal critical value of Caprini score was 9.5, and the area under the ROC curve was 0.684 (95% CI: 0.597-0.772, P<0.01) . Conclusions:Caprini risk stratification can effectively predict the high-risk population of preoperative DVT in patients with hip fractures. Clinical nurses should focus on the thrombosis prevention and nursing of patients with extremely high-risk and high-risk hip fractures.
