Padua Risk Assessment Model And Infrared Thermal Imaging Technology Screening Value Of Venous Thromboembolism For Patients With Respiratory Medicine

Part One Validity of Padua risk assessment model in identifying high venous thromboembolism risk patients among hospitalized respiratory department patients ObjectiveTo test the Validity of Padua risk assessment model in identifying high venous thromboembolism(VTE)risk patients among hospitalized respiratory department patients.MethodsA retrospective case-control study was conducted to collect VTE patients diagnosed in the Department of Respiratory Medicine of First Affiliated Hospital of Guangzhou Medical University from January 2013 to December 2016.With a 2: 1 ratio,random number table method was used to select the control group which was hospitalized in the respiratory medicine department at the same time and discharged to diagnose non-VTE.Using Excel to register data on the general conditions,medical history,and laboratory test results of two groups.On the second day of hospitalization,patients were scored using the Padua risk assessment model to assess the risk of VTE.To compare the scores of both groups and analyze the relationship of VTE and different risk factors.Results320 patients in the VTE group and 640 in the control group.The average Padua risk score in cases with VTE was significant higher than that in controls(3.07±1.93 vs 1.32±1.53.P <0.05).As the score increased,the risk of VTE increased accordingly.Further analysis showed that already known thrombophilic condition and previous VTE were the key risk factors of VTE.The sensitivity and specificity of the Padua risk assessment model for screening VTE among hospitalized respiratory department patients were 46.25% and 90.31%.The area under the curve(AUC)is 0.758(P<0.05).ConclusionsThe Padua risk assessment model can not effectively screen high risk patients with VTE in respiratory medicine.As for Chinese patient population characteristics,it is needed to verify and improve various risk factors in Padua risk assessment model.Part Two Padua risk assessment model and infrared thermal imaging technology screening value of Deep venous thrombosis for patients with respiratory medicineObjective To evaluation the effectiveness of Deep venous thrombosis(DVT)by Padua risk assessment model and Infrared thermal imaging(IRTI)in the Screening of Venous Thromboembolism among hospitalized respiratory department patients.Methods A prospective study was conducted to evaluate the Padua risk assessment model of inpatients in the Department of Respiratory Medicine of the First Affiliated Hospital of Guangzhou Medical University from February 1,2017 to September 30,2017.According to the evaluation results,the patients were divided into high-risk group(Padua?4 points)and low-risk group(Padua<4 points),IRTI and Color doppler ultrasonography(CDU)were performed in 380 low-risk patients and 154 high-risk patients respectively.CDU was used as the diagnostic criteria to compare the diagnostic value of IRTI and related coagulation indexes in the diagnosis of venous thromboembolism.Two groups of patients were examined by infrared thermal imaging 3 months and 6 months after discharge and compare the risk of VTE.Results 1,282 cases of respiratory medical inpatients completed Padua risk assessment model.The evaluation result showed that 15.1% were high-risk patients with VTE,and 84.9% were low-risk patients with VTE.Color Doppler ultrasonography in 380 low-risk patients and 154 high-risk patients showed that the incidence of DVT was higher in the high-risk group(25.3%)than in the low-risk group(3.4%)P<0.05.IRTI showed that the proportion of high-risk DVT or highly suspected DVT was higher in the high-risk group(29.2%)than in the low-risk group(3.9%)P<0.05.With the increase of Padua risk score,the proportion of DVT increased.There was significant difference in FIB and plasma D-D between high-risk group and low-risk group(P<0.05),but there was no difference between PT,PTA and APTT(P>0.05).Infrared thermal imaging showed a good agreement between the overall patient and the high-risk group(Kappa,0.761,0.771,P<0.05),while it was generally consistent in the low-risk group(Kappa=0.629,P<0.05).High-risk patients and low-risk patients were followed up for 3 months and 6 months after discharge.Infrared thermal imaging showed that after 3 months of discharge,the rate of aggravation was no difference between two groups,but 6 months after discharge,the rate of aggravation was higher in the high-risk group(24.1%)than in the low-risk group(9.8%)P<0.05.Conclusions Department of Respiratory Medicine is a high-risk department for venous thromboembolism.Infrared thermal imaging has high sensitivity and specificity for the diagnosis of venous thromboembolism and is an accurate,reliable screening tool of DVT.The combination of Padua risk assessment model and infrared thermal imaging can effectively eliminate the diagnosis of inpatient DVT in respiratory medicine.High-risk patients with venous thromboembolism have a risk of venous thromboembolism in the long-term and prophylactic treatment of venous thromboembolism is required.