Diagnostic value of Caprini risk assessment model combined with D-dimer in perioperative venous thromboembolic disease of hysterectomy / 中国医师进修杂志

ABSTRACT

Objective:To evaluate the diagnostic value of the Caprini risk assessment model combined with D-dimer in perioperative venous thromboembolic (VTE) of hysterectomy.Methods:The clinical data of 160 patients who had underwent hysterectomy in Lianjiang City Maternal and Child Health Hospital from February 2017 to February 2019 were retrospectively analyzed. During perioperative period, VTE occurred in 80 patients (VTE group), and 80 patients had no VTE (control group). The sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, negative likelihood ratio and Youden index of Caprini risk assessment model, D-dimer level detection and Caprini risk assessment model combined with D-dimer in the diagnosis of VTE were analyzed and compared, and the diagnostic efficacy was evaluated by receiver operating characteristic (ROC) curve.Results:The positive rates of Caprini risk assessment model and D-dimer in VTE group were significantly higher than those in control group 87.50% (70/80) vs. 17.50% (14/80) and 90.00% (72/80) vs. 41.25% (33/80), and there was statistical difference ( P<0.05). The sensitivity, specificity, negative predictive value, positive predictive value, negative likelihood ratio, positive likelihood ratio and Youden index of the Caprini risk assessment model were 87.50% (70/80), 82.50% (66/80), 86.84% (66/76), 83.33% (70/84), 0.15, 0.50 and 0.70, respectively; the indexes of D-dimer were 90.00% (72/80), 58.75% (47/80), 85.45% (47/55), 68.57% (72/105), 0.17, 2.18 and 0.49, respectively; the indexes of Caprini risk assessment model combined with D-dimer were 97.50% (78/80), 52.50% (42/80), 95.45% (42/44), 67.24% (78/116), 0.05, 2.05 and 0.50, respectively. The areas under curve of Caprini risk assessment model, D-dimer and Caprini risk assessment model combined with D-dimer were 0.888, 0.877 and 0.945 (95% CI 0.833 to 0.943, 0.820 to 0.933 and 0.908 to 0.983, P < 0.01). Conclusions:Caprini risk assessment model and D-dimer have good results in the diagnosis of perioperative VTE of hysterectomy, and Caprini risk assessment model combined with D-dimer has the highest diagnostic value.