住院精神疾病患者并发VTE危险因素分析及预测模型构建  

Risk factors of VTE in hospitalized psychiatric patients and establishment of prediction model

作　　者：王剑英[1] 尚超娜 张俊蕾[1] 宋涛 李洁[1] 严艳 张冬红[1] Wang Jianying;Shang Chaona;Zhang Junlei;Song Tao;Li Jie;Yan Yan;Zhang Donghong(The Second Affiliated Hospital of Xinxiang Medical University,Xinxiang 453002,Henan,China)

机构地区：[1]新乡医学院第二附属医院,河南新乡453002

出　　处：《临床心身疾病杂志》2023年第3期35-40,共6页Journal of Clinical Psychosomatic Diseases

基　　金：新乡市科技攻关计划项目(编号GG2021036)。

摘　　要：目的分析精神疾病住院患者并发静脉血栓栓塞症的危险因素,构建风险预测模型。方法采用单因素分析及Logistic回归分析探究患者并发静脉血栓栓塞症的影响因素,建立精神疾病患者并发静脉血栓栓塞症的模型,采用Hosmer-Lemeshow检验评估模型的拟合度,绘制受试者工作特征曲线检测模型的预测效能。结果有下肢深静脉血栓史和下肢水肿史、营养风险≥3分、持续卧床时间≥48 h、联合使用抗精神病药物、日饮水量<1500 ml均为影响精神疾病患者并发静脉血栓栓塞症的独立危险因素(P<0.05)。精神疾病患者并发静脉血栓栓塞症的风险预测模型,Hosmer-Lemeshow检验的χ^(2)=4.53(P>0.05),模型预测静脉血栓栓塞的曲线下面积为0.858,95%CI为0.797~0.920。结论多种因素影响精神疾病患者并发静脉血栓栓塞症,风险预测模型能够很好的预测其静脉血栓栓塞的发生,为临床医护人员早期识别、及时展开针对性的干预措施提供了参考依据。Objective To analyze the risk factors of venous thromboembolism(VTE)in hospitalized psychiatric patients and construct the risk prediction model.Methods Univariate analysis and logistic regression analysis were used to explore the influencing factors of patients complicated by VTE,risk prediction model of psychiatric patients complicated by VTE was constructed,Hosmer-Lemeshow(HL)test used to evaluate the R-squared of model,and receiver operating characteristic(ROC)curve charted to detect the predictive effectiveness of risk prediction model.Results Deep vein thrombosis and edema history of lower extremities,nutritional risk≥3 points,duration of bed rest≥48 hours,combined use of antipsychotic drugs,daily water intake<1500 ml were all independent risk factor influencing psychiatric patients complicated by VTE(P<0.05).Chi-square value of the HL test wasχ^(2)=4.53(P>0.05),the area under the curve of VTE predicted by the model 0.858,and the 95%CI 0.797~0.920.Conclusion Multiple factors affect the occurrence of the VTE in mental patients,risk prediction model could effectively predict the occurrence of VTE and provides references for clinical medical staff to early identify and carry out targeted interventions timely.

关 键 词：精神疾病 住院患者 静脉血栓栓塞 危险因素 预测模型 

分 类 号：R749[医药卫生—神经病学与精神病学]