Padua 评分预测重症患者静脉血栓 栓塞症风险的价值

Value of Padua scores in predicting risk of venous thromboembolism in severe patients

摘要:

目的 探讨Padua 评分对预测重症患者发生静脉血栓栓塞症（VTE）风险的有效性。方法 采用 病例对照的方法进行回顾性研究，选取华北理工大学附属医院重症医学科（ICU）患者中确诊的78 例VTE 患者（VTE 组）及同时期同科室随机抽取的96 例未患VTE 患者（非VTE 组）。依据Padua 评分对两组患者 进行评分和危险分层。比较两组评分结果以及危险等级之间的关系，采用多因素Logistic 回归模型分析危险因素 与VTE 发生之间的关系。结果 VTE 组Padua 评分与非VTE 组比较，差异有统计学意义（P <0.05），VTE 组高于 非VTE 组，高评分等级组患者发生VTE 的风险是低评分等级组的7.66 倍。以ICU 住院患者的相关因素作为自 变量进行Logistic 回归分析发现：卧床≥ 3 d 是ICU 住院患者发生VTE 的最高级别的危险因素。结论 Pauda 评 分可较好地评估ICU 患者VTE 发病的危险程度。

Abstract:

Objective To test the validity of identifying the risk of venous thromboembolism (VTE) in severe inpatients with Padua risk assessment model. Methods In the retrospective case-control study, 78 inpatients with VTE (VTE group) and 96 inpatients without VTE (non-VTE group) admitted to the Intensive Care Unit (ICU) of Affiliated Hospital in North China University of Science and Technology from January 2015 to January 2017 were conducted in the same model. The risk of VTE was assessed according to the Padua risk assessment model, and the relationships between the scores and the dangerous levels were studied and compared between the two groups. The associations between the risk factors and VTE were analyzed with multivariate logistic regression analysis model. Results The average Padua risk scores in the patients with VTE were significant higher than those in the patients without VTE (P < 0.05). Compared with the patients with low scores, those with high scores were associated with 7.66-fold risk of VTE. From the logistic regression analysis on the relative factors in the severe inpatients, the most dangerous risk factor was bed rest of 3 or more days. Conclusions Padua risk assessment model can effectively predict the risk of VTE in severe inpatients.