The Screening Value Of Padua Score Combined With D-dimer In VTE Of The Department Of Respiratory

Objective:By comparing the predictive effect of Padua score,D-dimer and Padua score combined with D-dimer on VTE,to explore the screening value of Padua score combined with D-dimer in VTE of the department of respiratory.Methods:A total of 179 suspected VTE inpatients from the Department of Respiratory of The First Affiliated Hospital of Shanxi Medical University from January 2017 to February 2018 were collected and divided into VTE group and non-VTE group according to the results of V / Q scan and / or CTPA examination or upper and lower limb vein ultrasound.Perform a Padua score and collect D-dimer test values for all included patients,and calculate the Padua score,D-dimer and Padua score + D-dimer sensitivity,specificity,Youden index,best cut point,area under the ROC curve further explores the value of the three for screening VTE.Results:Among the 179 suspected VTE patients,83 were diagnosed with VTE(46.4%),and96 were excluded(53.6%).Padua score predicts that the optimal cut-off point of VTE for inpatients in the Department of Respiratory and Critical Diseases is 4 points,specificity is 85.54%,sensitivity is 63.54%,Youden index is 0.49,area under the ROC curve is0.805 [95% CI(0.739,0.860)];D-dimer predicts that the optimal cut-off point of VTE for inpatients in the Department of Respiratory and Critical Diseases is 0.55 mg / L,specificity is 65.06%,sensitivity is 84.37%,Youden index is 0.494,area under the ROC curve is 0.810;When Padua score ? 4 points and D-dimer ? 0.55 mg / L,the sensitivity of predicting of VTE for inpatients in the Department of Respiratory and Critical Diseases was 81.93%,the specificity was 82.29%,the Youden index was 0.64,and area under the ROC curve was 0.891 [95% CI(0.835,0.932)].The area under the ROC curve of Padua score combined with D-dimer for predicting VTE in inpatients in the Department of Respiratory and Critical Diseases was statistically significant when compared with Padua score or D-dimer alone(Z = 3.568,P = 0.0004;Z = 3.035,P = 0.0024),there was no significant difference between the area under the ROC curve of the Padua score and D-dimer for predicting VTE in hospitalized patients in the respiratory department(Z =0.126,P = 0.8996).Conclusion:Padua score combined with D-dimer can better predict the occurrence of VTE in inpatients in the department of respiratory and critical diseases,and help clinicians to screen out patients at high risk of VTE.