Predictive Value of Caprini Venous Thromboembolism Risk Assessment Model for Deep Vein Thrombosis in Intensive Care Unit Non-surgical Patients

Xin Zhang,Miaohang Shan,Wanxian Lu

doi:10.11648/j.ajim.20200801.18

Abstract

Objective: By evaluating the relationship between deep vein thrombosis (DVT) in intensive care unit (ICU) non-surgical patients and Caprini venous thromboembolism risk assessment model (Caprini model for short), the predictive value of Caprini model in ICU non-surgical patients was analyzed. Methods: 200 ICU non-surgical inpatients in the first affiliated hospital of Jinan university from April to September 2019 were retrospectively analyzed. General data of patients and the number of new DVT events were collected, and Caprini model was used for scoring the risk of venous thromboembolism (VTE). Results: There were 31 patients with DVT, accounting for 15.50%, and 169 patients without new DVT (non-DVT). Caprini model score was 9.03±2.70 in patients with DVT, higher than that in patients without DVT (6.80±2.48, P<0.001). 24 (12.00%) non-surgical ICU patients were at high risk of VTE and 171 cases (85.50%) were at very high risk. Only one patient with DVT was at high risk of VTE (3.23%), while the other 30 patients were at very high risk of VTE (96.77%). There were 1 case in low risk of VTE (0.59%), 4 cases in medium risk (2.37%), 23 cases in high risk (13.61%) and 141 cases in very high risk (83.43%) in non-DVT group. There was no significant difference in VTE risk stratification between DVT patients and non-DVT patients (P=0.063). The receiver operating characteristic (ROC) curve was plotted by using Caprini model score to predict DVT. The area under the ROC curve was 0.731, and the 95% confidence interval was 0.663-0.791 (P<0.001). The optimal cut-off point was 7, the sensitivity was 74.19%, the specificity was 65.68% and Youden’s index was 0.3897. Conclusion: The incidence of high risk and very high risk of VTE in ICU non-surgical patients was high, and Caprini model could better predict the occurrence of DVT, so it was necessary to strengthen the nursing of ICU non-surgical patients and effectively prevent DVT.

Highlights

Venous thromboembolism (VTE) refers to the abnormal coagulation of blood in deep vein cavities, which blocks venous cavities and leads to venous returning disorders, mainly including deep vein thrombosis (DVT) and pulmonary thromboembolism (PE) [1]
Clinical data and laboratory examination results of all patients included in the study were collected, and the Caprini model was evaluated by professionally trained nurses within 8h of admission, and risk stratification warnings were performed
The formation of DVT of lower limbs was diagnosed by doppler ultrasound examination of deep vein of lower limbs conducted by two professional ultrasound doctors

Summary

Introduction

Venous thromboembolism (VTE) refers to the abnormal coagulation of blood in deep vein cavities, which blocks venous cavities and leads to venous returning disorders, mainly including deep vein thrombosis (DVT) and pulmonary thromboembolism (PE) [1]. In the United States, about 478,000 fatal VTE events occurred each year [2]. DVT often occurred in the lower limb vein. Studies had shown that 3/4 of DVT occurred in non-surgical patients of internal medicine and only 25% patients who die of VTE in general hospitals had a recent surgical history, while the rest were non-surgical patients of internal medicine, accounting for 10% of the total deaths of internal medicine patients [3, 4]. Intensive care unit (ICU) patients were especially at high risk of DVT. Chinese studies reported that the incidence of DVT in ICU patients was from 9.7% to 27.0%, while reports in Western countries were as high as from 24% to 40%. Early risk assessment and prevention were crucial to reduce the incidence of DVT in ICU patients

Methods

Results

Conclusion