ABSTRACT
Objective:
To analyze the preventive effect of Caprini model on
venous thromboembolism (VTE) in
coma patients after severe
craniocerebral trauma.
Methods:
A total of 190
patients with severe
craniocerebral trauma who received
treatment in Lishui City People's
Hospital,
China between January 2015 and April 2019 were randomly divided into a
control group and an
observation group ( n = 95/group).
Patients in the
control group underwent the conventional strategy to prevent
lower extremity VTE.
Patients in the
observation group were subjected to individualized
strategies to prevent
lower extremity VTE based on Caprini model assessment. The drop-out rate and
treatment outcome were compared between the control and
observation groups. The proportion of
patients developing VTE during
treatment in Department of
Intensive Care Unit and the changes in coagulation indexes relative to before
treatment were compared between the two groups.
Results:
There was no significant difference in drop-out rate between the control and
observation group [10.53% (10/95) vs. 8.42% (8/95), χ2 = 0.245, P < 0.05]. The proportion of
patients developing VTE in the
observation group was significantly lower than that in the
control group [2.30% (2/87) vs. 10.59% (9/85), χ2 = 4.935, P < 0.05]. At 7 days after
surgery, the coagulation indices D-dimer,
platelet count,
prothrombin time,
activated partial thromboplastin time in the
observation group were (2.27 ± 0.43) mg/L, (281.62 ± 37.29) × 10 9/L, (12.93 ± 2.87) seconds and (34.35 ± 7.19) seconds, respectively, which were (3.31 ± 0.68) mg/L, (303.28 ± 39.96) × 10 9/L, (11.24 ± 2.46) seconds and (31.16 ± 6.82) seconds, respectively in the
control group. The coagulation indices in the
observation group were significantly superior to those in the
control group ( t = 10.013, 3.070, -3.463, -2.493, all P < 0.05).
Conclusion:
The Caprini model is effective in preventing VTE in
patients with
coma after
surgery for severe
traumatic brain injury. It deserves to be clinically applied.