Impact of Combining Ultrasound Parameter and the Caprini Score on Predicting Lower Extremity Deep Venous Thrombosis After Orthopedic Surgery.

IF 0.9 4区医学 Q3 SURGERY Annali italiani di chirurgia Pub Date : 2025-01-01 DOI:10.62713/aic.3861

Xi Chen, Yungwei Chi, Shengjun Ta, Li An, Fen Gu, Feng Tian, Ming Yan, Liwen Liu

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Abstract

Aims: This study combined a new ultrasound venous filling degree (VFD) parameter with the Caprini score to assess the clinical value of the Caprini score in predicting deep venous thrombosis (DVT) of the lower extremities.

Methods: This retrospective study included 150 inpatients undergoing orthopedic lower extremity surgery at the First Affiliated Hospital of the Air Force Medical University between June 2023 and June 2024. They included 41 (27.3%) cases of knee arthroplasty, 32 (21.3%) hip arthroplasty, 30 (20%) knee arthroscopy, 28 (18.7%) lower limb fractures, 12 (8%) bone tumor, and 7 (4.7%) cases of other surgery types. The data collected involved preoperative vein diameter, flow velocity, blood flow, venous lumen cross-sectional perimeter (C), lumen cross-sectional area (A), C2/A ratio (VFD) of the common femoral vein (CFV), femoral vein (FV), and popliteal vein (POV). The postoperative sonographic parameters and clinical data were compared between the DVT and non-DVT groups. Receiver operating characteristic (ROC) curve of parameters was evaluated as predictive values for DVT. Additionally, the C2/A ratio was combined with the Caprini score to assess their combined impact on DVT prediction.

Results: There were significant differences in ultrasound parameters of CFV inner diameter, CFV blood flow, CFV-C, CFV-A, CFV-C2/A, FV blood flow, FV-C, FV-C2/A, POV blood flow, POV-C, POV-A, and POV-C2/A between the DVT group (24.7%, 37/150) and the non-DVT group (75.3%, 113/150) (all p < 0 .05). Area under curve (AUC) for the C2/A (CFV, FV, and POV) were 0.939 (95% confidence interval (CI): 0.888-0.972, p < 0.001), 0.937 (95% CI: 0.886-0.970, p < 0.001), and 0.917 (95% CI: 0.861-0.956, p < 0.001), respectively. When the Caprini score >2, an AUC for predicting DVT was 0.844 (95% CI: 0.776-0.899, p < 0.001). The AUC of the Caprini score >2 combined with C2/A (CFV, FV, and POV) were 0.953 (95% CI: 0.905-0.981, p < 0.001), 0.965 (95% CI: 0.922-0.988, p < 0.001), and 0.948 (95% CI: 0.900-0.978, p < 0.001), respectively.

Conclusions: The ultrasound parameter of VFD-C2/A shows a high predictive value for DVT in patients undergoing orthopedic surgery. Combined with the Caprini score, the predictive value of DVT may be further enhanced compared to using the Caprini score alone.

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超声参数与卡普里尼评分相结合对预测矫形外科手术后下肢深静脉血栓形成的影响

目的：本研究将一种新的超声静脉充盈度（VFD）参数与capriti评分相结合，评价capriti评分在预测下肢深静脉血栓形成（DVT）中的临床价值。方法：对2023年6月至2024年6月在空军医科大学第一附属医院接受骨科下肢手术的住院患者150例进行回顾性研究。其中膝关节置换术41例（27.3%），髋关节置换术32例（21.3%），膝关节镜手术30例（20%），下肢骨折28例（18.7%），骨肿瘤12例（8%），其他手术7例（4.7%）。收集的数据包括术前静脉直径、流速、血流、静脉管腔横截周长(C)、管腔横截面积(A)、C2/A比值（VFD），分别为股总静脉（CFV）、股静脉（FV）、腘静脉（POV）。比较DVT组与非DVT组术后超声参数及临床资料。评价参数的受试者工作特征（ROC）曲线作为DVT的预测值。此外，将C2/A比值与capriti评分相结合，以评估它们对DVT预测的综合影响。结果：DVT组CFV内径、CFV血流量、CFV- c、CFV-A、CFV- c2 /A、FV血流量、FV- c、FV- c2 /A、POV血流量、POV- c、POV-A、POV- c2 /A超声参数与非DVT组（75.3%,113/150）比较差异均有统计学意义（p均< 0.05）。C2/A （CFV、FV和POV）的曲线下面积（AUC）分别为0.939（95%可信区间（CI） 0.888 ~ 0.972, p < 0.001）、0.937 （95% CI: 0.886 ~ 0.970, p < 0.001）和0.917 （95% CI: 0.861 ~ 0.956, p < 0.001）。当capriti评分为bb0.2时，预测DVT的AUC为0.844 （95% CI: 0.776-0.899, p < 0.001）。Caprini评分>2合并C2/A （CFV、FV、POV）的AUC分别为0.953 （95% CI: 0.905 ~ 0.981, p < 0.001）、0.965 （95% CI: 0.922 ~ 0.988, p < 0.001）、0.948 （95% CI: 0.900 ~ 0.978, p < 0.001）。结论：VFD-C2/A超声参数对骨科手术患者DVT有较高的预测价值。与单独使用Caprini评分相比，联合使用Caprini评分可进一步提高DVT的预测价值。

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来源期刊

Annali italiani di chirurgia 医学-外科

CiteScore

0.90

自引率

12.50%

发文量

116

审稿时长

>12 weeks

期刊介绍： Annali Italiani di Chirurgia is a bimonthly journal and covers all aspects of surgery:elective, emergency and experimental surgery, as well as problems involving technology, teaching, organization and forensic medicine. The articles are published in Italian or English, though English is preferred because it facilitates the international diffusion of the journal (v.Guidelines for Authors and Norme per gli Autori). The articles published are divided into three main sections:editorials, original articles, and case reports and innovations.