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老年住院患者PICC相关深静脉血栓风险评估模型研究

刘芬 郭豫涛 徐月 刘心菊 李燕 侯惠如   

  1. 解放军总医院南楼临床部,100853 北京市(刘芬,郭豫涛,徐月,刘心菊,李燕,侯惠如);联参警卫局卫生保健处(刘芬)
  • 出版日期:2017-04-25 发布日期:2017-04-25
  • 基金资助:
    总后勤部卫生部保健专项科研课题(14BJZ05)

A risk assessment model for Peripherally Inserted Central Catheter related deep vein thrombosis in elderly inpatients

  • Online:2017-04-25 Published:2017-04-25

摘要: 目的:确定PICC-DVT高危因素,构建PICC-DVT风险评估模型。方法:回顾性分析2008年1月至2015年12月在我院行PICC置管的564例老年患者资料。应用Cox比例风险模型确定PICC-DVT危险因素并建立风险评估模型;用Jonckheere趋势检验评估不同危险分层患者PICC-DVT差异,并通过构建受试者工作特征曲线(ROC),评价模型预测价值。结果:房颤、动脉粥样硬化、近期手术史、静脉血栓史是老年住院患者PICC-DVT的独立危险因素(P<0.05)。PICC-DVT风险指数=1.302χ1(静脉血栓史)+0.775χ2(近期手术史)+0.596χ3(房颤)+0.610χ4(动脉粥样硬化)。PICC-DVT发生率随风险指数升高而增加(P<0.05)。该模型ROC曲线下面积为0.73。结论:房颤、动脉粥样硬化、近期手术史、静脉血栓史是老年住院患者PICC-DVT的独立危险因素,PICC-DVT风险评估模型预测效能良好。

Abstract: Objective: To identify risk factors for Peripherally Inserted Central Catheter (PICC)-related Deep Vein Thrombosis (DVT) in elderly inpatients and develop a predict model of PICC-DVT. Methods: The data from 564 elderly inpatients receiving a PICC in PLA General Hospital between January 2008 and December 2015 were retrospectively analyzed. Cox proportional hazards model was used to identify risk factors and develop the PICC-DVT risk assessment model. The patients were stratified by risk of PICC-DVT using Jonckheere trend test. The model was evaluated by receiver operating characteristic curve (ROC). Results: Atrial fibrillation (AF), atherosclerosis, recent operation and prior vein thrombosis (VTE) were the key risk factors (P<0.05). PICC-DVT risk index=1.302χ1 (prior VTE) +0.775χ2 (recent operation)+0.596χ3 (AF)+0.610χ4 (atherosclerosis). With the increase of risk index, the incident of PICC-DVT increased significantly. The area below the ROC curve of the model was 0.73. Conclusion: AF, atherosclerosis, recent operation and prior VTE were the independent risk factors of PICC-DVT. The predict model is reliable in predicting PICC-related deep venous thrombosis.