Using the Padua prediction score and the bleeding risk score for the assessment of venous thromboembolism and hemorrhage risk factors in elderly patients with choledocholithiasis undergoing endoscopic retrograde cholangiopancreatography
10.3760/cma.j.issn.0254-9026.2022.06.016
- VernacularTitle:Padua评分模型和出血风险评估模型在行经内镜逆行胰胆管造影术老年胆总管结石患者静脉血栓栓塞症和出血风险因素分析中的应用
- Author:
Baibutihan AHEBAOTA
1
;
Zhiqiang ZHANG
;
Yu XIA
;
Hongliang GAO
Author Information
1. 新疆医科大学第一附属医院消化二科，乌鲁木齐 830054
- Keywords:
Cholangiopancreatography, endoscopic retrograde;
Choledocholithiasis;
Venous thromboembolism;
Hemorrhage
- From:
Chinese Journal of Geriatrics
2022;41(6):695-699
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the value of the Padua prediction score and the bleeding risk score in the risk assessment of venous thromboembolism(VTE)and hemorrhage in elderly patients with choledocholithiasis during endoscopic retrograde cholangiopancreatography(ERCP).Methods:Clinical data of 171 elderly patients with choledocholithiasis treated with ERCP at the Affiliated Hospital of Xinjiang Medical University from September 2017 to September 2019 were retrospectively analyzed.The Padua prediction score and bleeding risk score were used to evaluate the occurrence of VTE and hemorrhage risk stratification.Results:Of all patients treated with the procedure, 18 of them had complications after surgery, including postoperative pancreatitis(9 cases), biliary infections(4 cases), hemorrhage(3 cases)and VTE events(2 cases). In addition, complications occurred in elderly patients in different age groups, with no significant difference in incidence(all P>0.05). Evaluation models showed that 32.7%(56/171)were at high risk for VTE, and 15.2%(26/171)were at high risk for hemorrhage.Furthermore, 2 VTE events occurred in the high-risk group and, of 3 hemorrhage events, 2 were occurred in the low-risk group and 1 in the high-risk group.There was no significant difference in the incidence of complications between the high-risk group and the low-risk group( χ2=0.000, 2.867, P=1.000, 0.090). Logistic regression analysis results showed that scores of the two assessment models were not influencing factors for VTE/hemorrhage(Padua prediction score: OR=8.383, 95% CI: 0.926-75.869, P=0.059; bleeding risk score: OR=2.860, 95% CI: 0.250-32.740, P=0.398). Conclusions:For elderly choledocholithiasis patients treated with ERCP, the Padua prediction score and the bleeding risk score have limited ability for risk assessment.More attention needs to be paid to the two VTE risk factors, i.e., malignant tumors and previous VTE history, in addition to previous bleeding risk for antithrombotic therapy.
