Caprini风险评估模型评估肿瘤患者PICC相关静脉血栓的有效性研究

Validation of the Caprini risk assessment model in peripherally inserted central catheter-related venous thrombosis in tumor patients

摘要:

目的：回顾性验证Caprini风险评估模型预测肿瘤患者经外周置入中心静脉导管（peripherally inserted central catheters，PICC）相关静脉血栓栓塞风险的有效性。方法：采用病例对照研究，收集2012年到2017年150名行PICC置管肿瘤患者的一般资料、置管资料。将确诊已发生PICC相关静脉血栓的肿瘤患者作为病例组，按照肿瘤类型相同采用1∶4配对方法，选取同期留置但未发生PICC相关静脉血栓的患者作为对照组，根据Caprini风险评估模型对2组患者分别评分并记录。比较Caprini评分情况，采用多因素logistic回归模型分析肿瘤患者发生PICC相关静脉血栓的危险因素，以及危险分级和肿瘤患者PICC相关静脉血栓发病风险的关系。结果：病例组患者Caprini风险评分（7.720±1.768）高于对照组（6.220±1.097）；病例组患者PICC相关静脉血栓组评分≥7分以上的患者比例高达72%，高于对照组，差异具有统计学意义（P=0.000）。以Caprini风险评估模型中危险因素作为自变量进行logistic回归分析显示：严重肺部疾病（OR=5.539，95%CI=1.799～17.053，P=0.003）、其他高危因素（OR=6.987，95%CI=2.105～23.196，P=0.001）、血栓史（OR=24.735，95%CI=3.624～168.822，P=0.001）3个因素是肿瘤患者PICC相关静脉血栓发生的主要危险因素。且随着评分的增加，患者发生PICC相关静脉血栓的风险随之增加。结论：Caprini血栓风险评估模型能够有效预测肿瘤患者PICC相关静脉血栓发生的风险，值得临床推广。

Abstract:

Objective：To retrospectively validate the Caprini risk assessment model for predicting the risk of peripherally inserted cen－tral catheter（PICC）-related venous thrombosis in tumor patients. Methods：A case-control study was conducted to collect general data and catheterization data from 150 patients who underwent PICC catheterization from 2012 to 2017. Tumor patients with confirmed PICC-related venous thrombosis were enrolled in case group，and according to the tumor type，the 1∶4 paring method was used to enroll catheterized patients without PICC-related venous thrombosis in control group. According to the Caprini risk assessment model，the two groups of patients were scored，recorded，and compared. A multivariate logistic regression analysis was performed to analyze risk factors，as well as the relationship between risk stratification and the risk of PICC-related venous thrombosis in tumor patients. Results：The Caprini score of the case group（7.720±1.768） was higher than that of the control group（6.220±1.097）. In the case group，the proportion of patients with a PICC-related venous thrombosis score of 7 or more was as high as 72%，which was signifi－cantly higher than that of the control group（P=0.000）. Logistic regression analysis with the risk factors as the independent variables showed that severe lung diseases（OR=5.539，95% CI=1.799 to 17.053，P=0.003），history of thrombosis（OR=24.735，95%CI=3.624 to 168.822，P=0.001），and other high-risk factors（OR=6.987，95%CI=2.105 to 23.196，P=0.001） were main risk factors for PICC-related venous thrombosis in tumor patients. Conclusion：The Caprini risk assessment model can effectively predict the risk of PICC-related venous thrombosis in tumor patients and is worthy of clinical promotion.