ICU老年非手術(shù)病人靜脈血栓栓塞癥風(fēng)險預(yù)測模型的構(gòu)建及驗證

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Construction and validation of the prediction model for venous thromboembolism risk in elderly non?surgical patients in ICU

YANG Xing， MA Shasha， XU Hongmei， CHEN Xiaolin， LIU Li， SHANG Quanmei

Binzhou Medical College， Shandong 256600 China

Corresponding Author  XU Hongmei， E?mail： [email protected]

Abstract  Objective：To explore the risk factors of venous thromboembolism （VTE） in elderly non-surgical patients in ICU， and to construct and verify the nomogram prediction model.Methods：The clinical data of 524 patients in the ICU of a tertiary grade A hospital in Binzhou from January 2017 to January 2022 were collected retrospectively.According to whether VTE occurred， the patients were divided into VTE group and non?VTE group.The risk factors of VTE were analyzed by logistic regression，and the Nomogram prediction model was constructed.Results：Among 524 patients，166 occurred VTE，with an incidence of 31.7%.Multivariate Logistic regression analysis showed that braking time，stroke，VTE history，varicose veins of the lower extremities，vasoactive drugs，D?Dimer and fibrinogen were the predictors of VTE in elderly non?surgical patients with ICU.The Nomogram model was constructed by using the above seven prediction factors.After bootstrap repeated sampling 1 000 times， the Nomogram model was internally verified，and the calibration curve was drawn，which showed that the calibration curve fitted well with the ideal curve.The Hosmer?Lemeshow goodness of fit test showed that χ2=8.460，P=0.390.The calculated C?index was 0.869，the AUC was 0.871，the sensitivity was 0.729，the specificity was 0.891，and the accuracy was 81.49%，suggesting that the discrimination of the model was good.The decision curve analysis （DCA） showed that the model had good clinical effectiveness.Conclusions：We construct a Nomogram model based on the risk factors of VTE in elderly non-surgical patients in ICU，and it is verified that this model has good prediction efficiency and clinical effectiveness，so that medical staff can predict the occurrence of VTE early and accurately and take targeted intervention measures.

Keywords    venous thromboembolism，VTE；ICU； risk factors； prediction model； Nomogram； investigation

摘要  目的：調(diào)查重癥監(jiān)護室（ICU）老年非手術(shù)病人發(fā)生靜脈血栓栓塞癥（VTE）的危險因素，構(gòu)建列線圖預(yù)測模型并進行驗證。（剩余12422字）