三种血栓评分量表对老年髋部骨折后并发深静脉血栓的预测价值
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作者Author单位AddressE-Mail
陈晓 CHEN Xiao 内江市第一人民医院骨科, 四川 内江 641000 Department of Orthopaedics, the First People's Hospital of Neijiang, Neijiang 641000, Sichuan, China 342918992@qq.Com 
段延辑 DUAN Yan-ji 内江市第一人民医院骨科, 四川 内江 641000 Department of Orthopaedics, the First People's Hospital of Neijiang, Neijiang 641000, Sichuan, China  
陈昶 CHEN Chang 内江市第一人民医院骨科, 四川 内江 641000 Department of Orthopaedics, the First People's Hospital of Neijiang, Neijiang 641000, Sichuan, China  
曹源 CAO Yuan 内江市第一人民医院骨科, 四川 内江 641000 Department of Orthopaedics, the First People's Hospital of Neijiang, Neijiang 641000, Sichuan, China  
期刊信息:《中国骨伤》2023年,第36卷,第12期,第1125-1129页
DOI:10.12200/j.issn.1003-0034.2023.12.004
基金项目:
中文摘要:

目的:探讨Caprini、Wells及Autar 3种评分量表对老年髋部骨折后发生下肢深静脉血栓(deep venous thrombosis,DVT)的预测价值。

方法:选择2018年1月至2022年9月收治的310例老年髋部骨折患者,根据患者下肢彩超检查结果,将并发DVT的患者作为血栓组(155例),男42例,女113例,年龄60~101(80.58±8.84)岁;未并发DVT的患者作为对照组(155例),男58例,女97例,年龄60~94(79.01±8.99)岁。收集并比较两组患者入院即刻的Caprini、Wells及Autar评分量表。采用受试者工作特征(receiver operating characteristic,ROC)曲线评价3种血栓风险评估表对老年髋部骨折后发生DVT的预测价值。

结果:血栓组Caprini、Wells及Autar评分明显高于对照组(P<0.001)。ROC曲线分析结果显示:Caprini评分最佳截断值为8.5分,灵敏度46.5%,特异度99.4%,曲线下面积(area under the curve,AUC)为0.763;Wells评分最佳截断值为1.5分,灵敏度100%,特异度99.4%,AUC为0.998;Autar评分最佳截断值为10.5分,灵敏度58.1%,特异度84.5%,AUC为0.717。

结论:Caprini、Wells及Autar评分对于老年髋部骨折患者发生DVT的风险均具有良好的预测效能,可为临床上指导老年髋部骨折后DVT的预防、管理和治疗提供重要参考,其中以Wells评估量表的预测价值较高。
【关键词】髋部骨折  深静脉血栓  Caprini量表  Wells量表  Autar量表
 
Predictive value of three kinds of thrombosis risk assessment scale for lower extremity deep vein thrombosis after hip fracture in elderly patients
ABSTRACT  

Objective To explore predictive value of Caprini score,Wells score and Autar score for lower extremity deep vein thrombosis (DVT) after hip fracture in elderly patients.

Methods A total of 310 elderly patients with hip fracture were selected from January 2018 to September 2022. According to the lower extremity color ultrasound examination results,155 patients with DVT were divided into thrombosis group,included 42 males and 113 females,aged from 60 to 101 years old with an average of (80.58±8.84) years old; and 155 patients without DVT were divided into control group,included 58 males and 97 females,aged from 60 to 94 years old with an average of (79.01±8.99) years old. Caprini score,Wells score and Autar score immediately after admission were collected and compared between two groups. Receiver operating characteristic (ROC) curve was used to evaluate predictive value of three thrombus risk assessment tables for DVT after hip fracture in elderly patients.

Results Caprini score,Wells score and Autar score in thrombus group were significantly higher than those in control group (P<0.001). ROC curve analysis results showed that the best cut-off value of Caprini score was 8.5 points,the sensitivity was 46.5%,the specificity was 99.4%,and area under the curve(AUC) was 0.763. The best cut-off value of Wells score was 1.5,the sensitivity was 100%,the specificity was 99.4%,and AUC was 0.998. The best cut-off value of Autar score was 10.5 points,the sensitivity was 58.1%,the specificity was 84.5%,and AUC was 0.717.

Conclusion Caprini scale,Wells scale and Autar scale all have good predictive efficacy for the risk of DVT in elderly patients with hip fracture,and could provide an important reference for clinical guidance for prevention,management and treatment of DVT after hip fracture in elderly patients,among which Wells scale has a higher predictive value.
KEY WORDS  Hip fracture  Deep venous thrombosis  Caprini scale  Wells Scale  Autar scale
 
引用本文,请按以下格式著录参考文献:
中文格式:陈晓,段延辑,陈昶,曹源.三种血栓评分量表对老年髋部骨折后并发深静脉血栓的预测价值[J].中国骨伤,2023,36(12):1125~1129
英文格式:CHEN Xiao,DUAN Yan-ji,CHEN Chang,CAO Yuan.Predictive value of three kinds of thrombosis risk assessment scale for lower extremity deep vein thrombosis after hip fracture in elderly patients[J].zhongguo gu shang / China J Orthop Trauma ,2023,36(12):1125~1129
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