开颅术后ICU老年患者下肢深静脉血栓的危险因素预测效能研究

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Study on the predictive efficacy of risk factors for lower extremity deep vein thrombosis in elderly icu patients post-craniotomy

Yang Tao1，Yu Shanshan² 1 Department of Critical Care Medicine，Beijing Tiantan Hospital，Capital Medical University，Beijing100070; 2 Department of Neurocritical Care， Jinyang Hospital AfiliatedofGuizhou Medical University，Guiyang SecondPeople'sHospital，Guiyang550023 ** Corresponding author：Yu Shanshan，email： yss_ ytO851@ 163.com

[Abstract]ObjectiveTo explore theriskfactors，predictive effcacyoflower extremitydeepvenous thrombosis（DVT）in elderly patients after craniotomy admited to the ICU.MethodsAretrospective studywas conducted in patients aged ⩾ 65 years after craniotomyadmitedtohedeparmentofriticalcaremedicineofBeijingTiantanHospital，CapitalMedicalUniversitfroJue22 to June2024.PatientsweredividedintoaDVTgroupandanon-DVTgroupbasedontheresultsoflowerextremityultrasoundexaminationsduring theirICUstayTheincidenceoflower extremityDVTwascalculated.Relevantdatafromboth groups wascollectedand compared.MultivariatelogisticregressionmodelwasusedtoanalyeteiskfactorsofDVformationinelderlyICUpatientsafteaniotomy，andaROCcurvewasusedtoasssthepredictivevalueofeach index.ResultsAtotalof190elderlypost-cranotomypatientsadmitedtotheICUwhocompletedlowerextremityultrasoundexaminationswereicludedinthestudy.Amongthem，3patients were diagnosed with lower extremity DVT（DVT group，incidence rate：68.95 % ），while 59 patients showed no evidence of DVT （non-DVTgroup）.Significantdiferences wereobservedbetweenthe twogroups inGlasgowComaScalescore，C-reactiveprotei，fibrindegradationproducts，D-dimer，and fibrinogen levels（all P<0.05 ）.Multivariate logistic regression analysis revealed that C-reactive proteinandD-dimer were independentrisk factorsforlower extremityDVTinelderlyICUpatientsaftercraniotomy（ P<0.05 ）： ROC curve analysis indicated that CRP>50.07mg/L [AUC（ 95%CI ）：0.597（0.505-0.689），P=0.033]andD-dimer > （2 6.52μg/mL [AUC（ 95%CI ）：0.802（0.738-0.867）， P<0.001 ]were the optimal cutoff values for predicting DVT. Conclusion In elderlypatientsundergoigcraiotoyndadmitedtotheICU，C-reactieproteinandD-dimerareindependentpredictoroflower extremity DVT.

[Key words] Lower extremity deep vein thrombosis；Post-craniotomy；C-reactive protein；D-dimer;Risk factors

既往研究表明，年龄与神经重症术后患者下肢深静脉血栓（Deepvenousthrombosis，DVT）的发生存在显著相关性，且年龄越大的患者越容易出现下肢 DVT[1-2] 。（剩余4218字）