Thrombosis Risk Assessment as a Guide to Quality Patient Care

风险评估 肺栓塞 深静脉 医学 梅德林 血栓形成 静脉血栓栓塞 队列研究 风险管理工具 重症监护医学 急诊医学 内科学 政治学 计算机安全 计算机科学 法学
作者
Joseph A. Caprini
出处
期刊:Dm Disease-a-month [Elsevier BV]
卷期号:51 (2-3): 70-78 被引量:802
标识
DOI:10.1016/j.disamonth.2005.02.003
摘要

Hospital-acquired venous thromboembolism (VTE, including pulmonary embolism [PE] and deep vein thrombosis [DVT]) is a preventable cause of hospital death. The Caprini risk assessment model (RAM) is one of the most commonly used tools to assess VTE risk. The RAM is operationalized in clinical practice by grouping several risk scores into VTE risk categories that drive decisions on prophylaxis. A correlation between increasing Caprini scores and rising VTE risk is well-established. We assessed whether the increasing VTE risk categories assigned on the basis of recommended score ranges also correlate with increasing VTE risk.We conducted a systematic review of articles that used the Caprini RAM to assign VTE risk categories and that reported corresponding VTE rates. A Medline and EMBASE search retrieved 895 articles, of which 57 fulfilled inclusion criteria.Forty-eight (84%) of the articles were cohort studies, 7 (12%) were case-control studies, and 2 (4%) were cross-sectional studies. The populations varied from postsurgical to medical patients. There was variability in the number of VTE risk categories assigned by individual studies (6 used 5 risk categories, 37 used 4, 11 used 3, and 3 used 2), and in the cutoff scores defining the risk categories (scores from 0 alone to 0-10 for the low-risk category; from ≥5 to ≥10 for high risk). The VTE rates reported for similar risk categories also varied across studies (0%-12.3% in the low-risk category; 0%-40% for high risk). The Caprini RAM is designed to assess composite VTE risk; however, two studies reported PE or DVT rates alone, and many of the other studies did not specify the types of DVTs analyzed. The Caprini RAM predicts VTE at 30 days after assessment; however, only 17 studies measured outcomes at 30 days; the remaining studies had either shorter or longer follow-ups (0-180 days).The usefulness of the Caprini RAM is limited by heterogeneity in its implementation across centers. The score-derived VTE risk categorization has significant variability in the number of risk categories being used, the cutpoints used to define the risk categories, the outcome being measured, and the follow-up duration. This factor leads to similar risk categories being associated with different VTE rates, which impacts the clinical and research implications of the results. To enhance generalizability, there is a need for studies that validate the RAM in a broad population of medical and surgical patients, identify standardized risk categories, define risk of DVT and PE as distinct end points, and measure outcomes at standardized follow-up time points.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
Dsunflower完成签到 ,获得积分10
刚刚
情怀应助Camellia采纳,获得10
刚刚
发一篇JACS发布了新的文献求助10
刚刚
ningwu完成签到,获得积分10
1秒前
yuancw完成签到 ,获得积分10
1秒前
keeptg完成签到 ,获得积分10
1秒前
binhunu完成签到,获得积分10
1秒前
ddd完成签到,获得积分10
1秒前
aliao发布了新的文献求助10
2秒前
廷烨完成签到,获得积分10
2秒前
2秒前
甜橙汁完成签到,获得积分10
3秒前
nieinei完成签到 ,获得积分10
3秒前
偷猪剑客完成签到,获得积分10
4秒前
id发布了新的文献求助200
4秒前
蓝妙弋完成签到 ,获得积分10
5秒前
ding应助青鹧采纳,获得10
5秒前
Ran-HT完成签到,获得积分10
5秒前
小狐狸完成签到,获得积分20
5秒前
JJ完成签到 ,获得积分10
5秒前
Yanan发布了新的文献求助10
6秒前
乐观的凌兰完成签到 ,获得积分10
6秒前
剑指天涯完成签到,获得积分10
6秒前
发一篇JACS完成签到,获得积分10
6秒前
SEER完成签到,获得积分10
6秒前
xiangpimei完成签到 ,获得积分10
7秒前
7秒前
优雅泡芙完成签到,获得积分10
7秒前
8秒前
AZE应助咳咳采纳,获得10
8秒前
8秒前
李爱国应助cuicui采纳,获得10
8秒前
wisdom应助牛爷爷采纳,获得10
8秒前
WW发布了新的文献求助10
8秒前
曾经高跟鞋完成签到,获得积分10
8秒前
9秒前
9秒前
Akim应助二大爷采纳,获得10
9秒前
星辰大海应助丶丶采纳,获得10
10秒前
Ava应助漂亮访风采纳,获得10
10秒前
高分求助中
A new approach to the extrapolation of accelerated life test data 1000
Cognitive Neuroscience: The Biology of the Mind 1000
Technical Brochure TB 814: LPIT applications in HV gas insulated switchgear 1000
Immigrant Incorporation in East Asian Democracies 600
Nucleophilic substitution in azasydnone-modified dinitroanisoles 500
不知道标题是什么 500
A Preliminary Study on Correlation Between Independent Components of Facial Thermal Images and Subjective Assessment of Chronic Stress 500
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 3968771
求助须知:如何正确求助?哪些是违规求助? 3513729
关于积分的说明 11169450
捐赠科研通 3249084
什么是DOI,文献DOI怎么找? 1794592
邀请新用户注册赠送积分活动 875258
科研通“疑难数据库(出版商)”最低求助积分说明 804740