The predicted value for venous thromboembolism based on a modified model of caprini combined with fasting blood glucose and D-dimer: a retrospective study
Abstract Background The Caprini risk assessment model (RAM) is a classical score that evaluates the risk of developing venous thromboembolism (VTE) aimed at patients with lower extremity fractures (LEF). However, the influencing factors of RAM pay more attention to clinical characteristic variables...
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BMC
2025-02-01
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| Series: | BMC Musculoskeletal Disorders |
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| Online Access: | https://doi.org/10.1186/s12891-024-08133-2 |
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| author | Ping Wang Yusi Yang Lin Zheng Xiaotong Qi Sheng Yan Honglin Dong |
| author_facet | Ping Wang Yusi Yang Lin Zheng Xiaotong Qi Sheng Yan Honglin Dong |
| author_sort | Ping Wang |
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| description | Abstract Background The Caprini risk assessment model (RAM) is a classical score that evaluates the risk of developing venous thromboembolism (VTE) aimed at patients with lower extremity fractures (LEF). However, the influencing factors of RAM pay more attention to clinical characteristic variables and recognized thrombophilia markers such as prothrombin, while ignoring the influence of other laboratory indicators on thrombosis. This is the first paper to screen predictive risk factors associated with VTE to modify the Caprini model and determine its diagnostic value. Results and methods We included 953 LEF patients from January 2019 to December 2021 and randomized them in a 7:3 ratio into a training set (n = 667) and a validation set (n = 286). Logistic regression and LASSO regression were used to screen for independent predictors of patients in the training set. Logistic regression screened for: age (OR 1.04, 95% CI 1.02—1.06), D-dimer (OR 1.06, 95% CI 1.03—1.08), Caprini (OR 1.17, 95% CI 1.08—1.27) and fasting blood glucose (FBG) (OR 1.18, 95% CI 1.03—1.35), which also appeared in the LASSO seven-factor model. In addition to Caprini and age, FBG and D-dimer may be important predictors of deep vein thrombosis in patients with LEF. Therefore, we constructed three models. caprini + D-dimer, caprini + FBG, and caprini + D-dimer + FBG. We compared them with caprini alone. Caprini + FBG + D-dimer showed the greatest ROC (0.784, 95% CI 0.730–0.837, Delong test P = 0.002 vs. Caprini’s ROC). D-dimer and FBG have a significant increase in the predictive effect for predicting DVT in terms of NRI (59.98% improvement, P < 0.001) and IDI (9.55% improvement, P < 0.001), showing the best net benefit for predicting DVT when the threshold probability was between 27 and 91%. Conclusions Caprini RAM combined with D-dimer and FBG can improve the diagnostic efficiency of Caprini alone and provide a new method to better predict the risk of VTE in LEF patients. |
| format | Article |
| id | doaj-art-5ba4f2050ad94ba2a82ef7d91ce6f295 |
| institution | Kabale University |
| issn | 1471-2474 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | BMC |
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| series | BMC Musculoskeletal Disorders |
| spelling | doaj-art-5ba4f2050ad94ba2a82ef7d91ce6f2952025-02-09T12:04:26ZengBMCBMC Musculoskeletal Disorders1471-24742025-02-0126111210.1186/s12891-024-08133-2The predicted value for venous thromboembolism based on a modified model of caprini combined with fasting blood glucose and D-dimer: a retrospective studyPing Wang0Yusi Yang1Lin Zheng2Xiaotong Qi3Sheng Yan4Honglin Dong5Department of Vascular Surgery, The Second Hospital of Shanxi Medical UniversityDepartment of Cardiology, Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences Tongji Shanxi HospitalDepartment of Vascular Surgery, The Second Hospital of Shanxi Medical UniversityDepartment of Vascular Surgery, The Second Hospital of Shanxi Medical UniversityDepartment of Vascular Surgery, The Second Hospital of Shanxi Medical UniversityDepartment of Vascular Surgery, The Second Hospital of Shanxi Medical UniversityAbstract Background The Caprini risk assessment model (RAM) is a classical score that evaluates the risk of developing venous thromboembolism (VTE) aimed at patients with lower extremity fractures (LEF). However, the influencing factors of RAM pay more attention to clinical characteristic variables and recognized thrombophilia markers such as prothrombin, while ignoring the influence of other laboratory indicators on thrombosis. This is the first paper to screen predictive risk factors associated with VTE to modify the Caprini model and determine its diagnostic value. Results and methods We included 953 LEF patients from January 2019 to December 2021 and randomized them in a 7:3 ratio into a training set (n = 667) and a validation set (n = 286). Logistic regression and LASSO regression were used to screen for independent predictors of patients in the training set. Logistic regression screened for: age (OR 1.04, 95% CI 1.02—1.06), D-dimer (OR 1.06, 95% CI 1.03—1.08), Caprini (OR 1.17, 95% CI 1.08—1.27) and fasting blood glucose (FBG) (OR 1.18, 95% CI 1.03—1.35), which also appeared in the LASSO seven-factor model. In addition to Caprini and age, FBG and D-dimer may be important predictors of deep vein thrombosis in patients with LEF. Therefore, we constructed three models. caprini + D-dimer, caprini + FBG, and caprini + D-dimer + FBG. We compared them with caprini alone. Caprini + FBG + D-dimer showed the greatest ROC (0.784, 95% CI 0.730–0.837, Delong test P = 0.002 vs. Caprini’s ROC). D-dimer and FBG have a significant increase in the predictive effect for predicting DVT in terms of NRI (59.98% improvement, P < 0.001) and IDI (9.55% improvement, P < 0.001), showing the best net benefit for predicting DVT when the threshold probability was between 27 and 91%. Conclusions Caprini RAM combined with D-dimer and FBG can improve the diagnostic efficiency of Caprini alone and provide a new method to better predict the risk of VTE in LEF patients.https://doi.org/10.1186/s12891-024-08133-2Prediction modelCaprini scoreD-dimerFasting blood sugarDeep vein thrombosisFracture |
| spellingShingle | Ping Wang Yusi Yang Lin Zheng Xiaotong Qi Sheng Yan Honglin Dong The predicted value for venous thromboembolism based on a modified model of caprini combined with fasting blood glucose and D-dimer: a retrospective study BMC Musculoskeletal Disorders Prediction model Caprini score D-dimer Fasting blood sugar Deep vein thrombosis Fracture |
| title | The predicted value for venous thromboembolism based on a modified model of caprini combined with fasting blood glucose and D-dimer: a retrospective study |
| title_full | The predicted value for venous thromboembolism based on a modified model of caprini combined with fasting blood glucose and D-dimer: a retrospective study |
| title_fullStr | The predicted value for venous thromboembolism based on a modified model of caprini combined with fasting blood glucose and D-dimer: a retrospective study |
| title_full_unstemmed | The predicted value for venous thromboembolism based on a modified model of caprini combined with fasting blood glucose and D-dimer: a retrospective study |
| title_short | The predicted value for venous thromboembolism based on a modified model of caprini combined with fasting blood glucose and D-dimer: a retrospective study |
| title_sort | predicted value for venous thromboembolism based on a modified model of caprini combined with fasting blood glucose and d dimer a retrospective study |
| topic | Prediction model Caprini score D-dimer Fasting blood sugar Deep vein thrombosis Fracture |
| url | https://doi.org/10.1186/s12891-024-08133-2 |
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