Patient-Completed Caprini Risk Score for Venous Thromboembolism Risk Assessment: Developed and Validated from 1,017 Medical and Surgical Patients.

Zhu Zhang, Yifan Wu, Qingxia Liu, Fen Dong, Wenyi Pang, Kaiyuan Zhe, Jun Wan, Wanmu Xie, Wei Wang, Peiran Yang, Aihua Sun, Zhenguo Zhai
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Abstract

Background  The Caprini Risk Score (CRS) is one of the most widely used risk assessment models for venous thromboembolism (VTE). A well-validated patient-completed CRS form may allow patients to self-report and simplify the evaluation by health care workers. Methods  The Chinese version of the CRS was optimized for easy understanding in a pilot study. The amended CRS form was completed by prospectively recruited patients and blinded nurses. The agreement levels of the individual questions and the total scores of patient and nurse-completed forms were compared using the Kappa value. The total scores were used for risk stratification of patients. Correlation and differences between patient and nurse-completed forms were analyzed using the Spearman correlation and Bland-Altman method, respectively. Results  We recruited 504 medical patients and 513 surgical patients, aged 52.7 ± 16.3 years, of which 443 (43.6%) were men, and 91.6% of the patients were educated beyond junior high school. The patients spent less time to complete the form compared with trained nurses. There was good question-to-question agreement between patient and nurse-completed CRS ( k >0.6 for most questions, p  < 0.0001). The total scores also showed good agreement ( k  = 0.6097, p  < 0.0001), and enabled the classification of patients into different risk groups. The patient and nurse-derived scores were highly correlated (Spearman's r  = 0.84), and without extreme values ( p  < 0.0001). Conclusion  We have created and verified a Chinese version of the patient-completed CRS, which showed good agreement and correlation with nurse-completed CRS. CRS represents a suitable tool for VTE risk assessment of hospitalized patients in China.

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静脉血栓栓塞风险评估的患者完成的Caprini风险评分:从1017名内科和外科患者中开发和验证。
capriini风险评分(CRS)是目前应用最广泛的静脉血栓栓塞(VTE)风险评估模型之一。一个经过验证的患者完成的CRS表格可以让患者自我报告,并简化卫生保健工作者的评估。方法在初步研究中对CRS中文版进行优化,使其易于理解。修改后的CRS表格由前瞻性招募的患者和盲眼护士完成。使用Kappa值比较个别问题的一致程度以及患者和护士填写的表格的总分。用总分对患者进行风险分层。分别采用Spearman相关和Bland-Altman方法分析患者与护士填写表格的相关性和差异。结果内科患者504例,外科患者513例,年龄52.7±16.3岁,其中男性443例(43.6%),初中以上文化程度占91.6%。与训练有素的护士相比,患者完成表格的时间更短。患者完成的CRS与护士完成的CRS存在较好的问题间一致性(大多数问题k >0.6, p k = 0.6097, p r = 0.84),且无极值(p)。结论我们创建并验证了中文版患者完成的CRS与护士完成的CRS具有较好的一致性和相关性。CRS是中国住院患者静脉血栓栓塞风险评估的合适工具。
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