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.
Subject(s)
Hip Fractures , Venous Thrombosis , Male , Female , Humans , Aged , Middle Aged , Aged, 80 and over , Venous Thrombosis/diagnosis , Venous Thrombosis/etiology , Risk Assessment , Hip Fractures/complications , Ultrasonography , Lower Extremity , Risk Factors , Retrospective StudiesABSTRACT
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.
Subject(s)
Male , Female , Humans , Aged , Middle Aged , Aged, 80 and over , Venous Thrombosis/etiology , Risk Assessment , Hip Fractures/complications , Ultrasonography , Lower Extremity , Risk Factors , Retrospective StudiesABSTRACT
Objective To explore the effect of Autar scale in risk assessment on deep venous thrombosis after stroke. Methods From March 2016 to March 2018, 234 stroke patients admitted to our hospital were selected in our study. According to the random digit table, they were divided into the control group and the observation group, 117 cases in each group. The patients in the control group were given routine nursing, while those in the observation group were given risk assessment by Autar scale, and the predictive nursing scheme was adopted based on the evaluation results. The two groups were compared in view of incidence of deep venous thrombosis. Self-rating depressive scale (SDS) and self-rating anxiety scale (SAS) were used to evaluate the mental status before and after intervention. Results The incidences of venous thrombosis and hospitalization time in the observation group were significantly lower than those in the control group (P<0.001). After the intervention, the scores of SDS and SAS in the two groups decreased significantly, and the mental state was basically at the normal level. The scores of SDS and SAS in the observation group were significantly lower than those in the control group (P<0.001). Conclusions Autar scale used for the risk assessment can effectively prevent deep venous thrombosis after stroke, help to improve the mental state of patients, and promote physical recovery of stroke patients. It has of high value for clinical application.
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Objective To compare predictive power for deep vein thrombosis among hip and knee joint replacement patients using Autar scale and Wells scale.Methods Convenience sampling method was used.Totally 331 patients from ten tertiary hospitals receiving hip and knee joint replacement were recruited.General information questionnaire,Autar scale and Wells scale were used to collect data.Telephone follow-up was performed at 2 weeks,1 month and 3 months after hospital discharge.The primary endpoint of follow-up was occurrence of DVT,and the secondary endpoint was no occurrence of DVT within 3 months after hospital discharge.Results The Cronbach's α coefficients of Autar scale ranged from 0.716 to 0.762 for scores 24h before operation,24h after operation and at the day of discharge,and those of Wells scale ranged from 0.580 to 0.603.The area under the ROC curve of Autar scale ranged from 0.726 to 0.798.The area under the ROC curve of Wells scale ranged from 0.568 to 0.628.Conclusion The predictive power of Autar scale was higher than that of Wells scale which enabled Autar scale to better predict deep vein thrombosis for patients receiving hip and knee joint replacement.
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Objective Early identification of deep vein thrombosis(DVT) risk in patients with joint arthroplasty helps to reduce the incidence of DVT.The study aimed to investigate the effectiveness of Autar risk assessment model in assessing DVT risk in patients with joint arthroplasty.Methods 72 patients with DVT from 10 hospitals from November 2014 to February 2016 were selected as the case group, and 144 non-DVP patients who hospitalized during the same period served as the control group.The medical history, laboratory tests and other related clinical data of the patients were collected, and Autar risk assessment scale was used to evaluate the patients.Multiple logistic regression was applied to analyze the relationship between the risk scale of DVT and the risk of DVT formation.Results 216 patients were included in the research.The Autar score of DVT patients (17.09±2.83) in case group was higher than that of control group (14.25±2.46) and the difference is of statistical significance(P<0.05).The area under the ROC curve of Autar scale in case group was 0.789 (95%CI: 0.719, 0.858,P<0.05).When the ROC curve cutoff point was 15, the sensitivity and the specificity of Autar scale were 88.57% and 57.90% respectively.In Autar scale, the main risk factors of DVT incidence were age≥70 years old, BMI≥30, strict bed rest, varicose veins, lower limb injuries and orthopedic surgery.The result of logistic regression analysis showed the difference of Autar risk rating between these two groups was of statistical significance(P<0.05).In comparison with low risk group, the DVT risk of patients with joint arthroplasty at medium risk was of no significant difference (OR=1.178, 95% CI: 0.733-1.490, P=0.053) while that of patients with joint arthroplasty at high risk was of significant difference (OR=5.536, 95% CI:3.577-7.132, P<0.001).Conclusion Autar DVT risk assessment scale assessed patients with joint arthroplasty at high risk are high risk group of DVT.The risk of DVT increases with the risk rating in patients with joint arthroplasty.Therefore, Autar risk assessment scale can be applied in the assessment of DVT risk in patients with joint arthroplasty.
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Objective To evaluate the application of Autar scale in the assessment of the risk of thrombosis related to peripherally inserted central catheter (PICC) in patients with lung cancer.Methods 1 252 cases of lung cancer with PICC between January 2008 and December 2012 in Shanghai Chest Hospital were enrolled as the control group,who received routine PICC insertion and maintenance.1 322 cases of lung cancer patients with PICC catheterization between January 2013 to May 2016 in the same hospital were recruited as the observation group,who were divided into low-risk,middle-risk and high-risk groups based on the scores of Autar scale,and given grading nursing intervention accordingly.Results In the control group,PICC-related thrombosis occurred in 38 cases (3.04%).In the observation group,PICC-related thrombosis occurred in 12 cases (0.91%),the incidence in the low-risk,middle-risk,and high-risk groups was 1.25% (5 cases),1.04% (5 cases),and 0.45% (2 cases),respectively.The incidence of thrombosis is lower in the observation group than in the control group (P < 0.05).Conclusions Aurar scale may help anticipate the risk of PICC-related upper extremity venous thrombosis in patients with lung cancer.Preventive nursing and treatment measures in lung cancer patients at high risk may effectively reduce the incidence of PICC catheter-related thrombosis.