Application value of Caprini model in the screening of deep venous thrombosis in neurosurgery patients admitted to intensive care unit

doi:10.3969/j.issn.1006-7795.2023.01.004

Abstract

Abstract: Objective To analyze the application value of Caprini model in the screening of deep venous thrombosis (DVT) within 7 d after neurosurgery. Methods Neurosurgery patients admitted to Department of Critical Care Medicine, Beijing Tiantan Hospital, Capital Medical University from January 2020 to June 2022 were selected. A total of 150 patients with DVT were included in the case group, while 300 hospitalized patients without DVT were included in the control group at a ratio of 1∶2. The general and clinical data were collected with the big data intelligent analysis platform. The DVT scores and risk classification were conducted based on the Caprini model. The Caprini model scores and the risk of DVT in patients with different DVT risk grades were compared to each other. The value of Caprini model in screening DVT was assessed with receiver operating characteristic (ROC) curve. Results According to the Caprini model, the mean Caprini score of the case group was 5.88±1.98, which was significantly higher than that in the control group 4.11±1.74 (P＜0.05). The DVT risk level of 450 patients was above moderate risk, including 93 patients in the moderate risk group (20.7%), 121 patients in the high risk group (26.9%), and 236 patients in the very high risk group (52.4%). The proportion of high risk exposure in the case group was significantly higher than that in the control group, and the risk of DVT in the very high risk group was 5.75 times that in the moderate risk group (P＜0.05). Logistic regression showed that age, Caprini model score and, D-dimer were independent influencing factors (P<0.05). The area under the ROC curve of Caprini model was 0.746 (95%CI: 0.696－0.796). When the score was 5.5, the sensitivity and specificity of DVT screening were 61.3% and 79.3%, respectively. The consistency between screening results and ultrasound diagnosis results was moderate (Kappa=0.404). Conclusion Caprini model can be used for preliminary screening of DVT within 7 d after craniocerebral surgery, but the sensitivity is low and the risk stratification of DVT needs to be optimized. Further research should be carried out to provide an effective assessment tool for screening or predicting the occurrence of DVT in severe craniocerebral surgery patients.

Key words: Caprini model, craniocerebral surgery, neurological critical illness, deep venous thrombosis, screening value, nursing

CLC Number:

R543

Zhang Ran, Cai Weixin, Shi Guangzhi, Wang Jun, Feng Yadi, Yuan Yuan, Zhao Jingwei, Yang Yanlin, Sun Xue, Tao Shuai. Application value of Caprini model in the screening of deep venous thrombosis in neurosurgery patients admitted to intensive care unit[J]. Journal of Capital Medical University, doi: 10.3969/j.issn.1006-7795.2023.01.004.

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