Abstract：
BACKGROUND: The risk of venous thromboembolism (VTE) following total hip arthroplasty (THA) and total knee arthroplasty (TKA) is 1.0% to 1.5%, despite uniform thromboprophylaxis.
OBJECTIVE: To develop and validate a prediction model for 90-day VTE risk.
METHODS: A multinational cohort study was performed. For model development, records were used from the Oxford Royal College of General Practitioners Research and Surveillance Centre linked to Hospital Episode Statistics and Office of National Statistics UK routine data. For external validation, data were used from the Danish Hip and Knee Arthroplasty Registry, the National Patient Registry, and the National Prescription Registry. Binary multivariable logistic regression techniques were used for development.
RESULTS: In the UK data set, 64 032 THA/TKA procedures were performed and 1.4% developed VTE. The prediction model consisted of age, body mass index, sex, cystitis within 1 year before surgery, history of phlebitis, history of VTE, presence of varicose veins, presence of asthma, history of transient ischemic attack, history of myocardial infarction, presence of hypertension and THA or TKA. The area under the curve of the model was 0.65 (95% CI, 0.63-0.67). Furthermore, 36 169 procedures were performed in the Danish cohort, of whom 1.0% developed VTE. Here, the area under the curve was 0.64 (95% CI, 0.61-0.67). The calibration slope was 0.92 in the validation study and 1.00 in the development study.
CONCLUSIONS: This clinical prediction model for 90-day VTE risk following THA and TKA performed well in both development and validation data. This model can be used to estimate an individual\'s risk for VTE following THA/TKA.
OBJECTIVE: To develop and validate a prediction model for 90-day VTE risk.
METHODS: A multinational cohort study was performed. For model development, records were used from the Oxford Royal College of General Practitioners Research and Surveillance Centre linked to Hospital Episode Statistics and Office of National Statistics UK routine data. For external validation, data were used from the Danish Hip and Knee Arthroplasty Registry, the National Patient Registry, and the National Prescription Registry. Binary multivariable logistic regression techniques were used for development.
RESULTS: In the UK data set, 64 032 THA/TKA procedures were performed and 1.4% developed VTE. The prediction model consisted of age, body mass index, sex, cystitis within 1 year before surgery, history of phlebitis, history of VTE, presence of varicose veins, presence of asthma, history of transient ischemic attack, history of myocardial infarction, presence of hypertension and THA or TKA. The area under the curve of the model was 0.65 (95% CI, 0.63-0.67). Furthermore, 36 169 procedures were performed in the Danish cohort, of whom 1.0% developed VTE. Here, the area under the curve was 0.64 (95% CI, 0.61-0.67). The calibration slope was 0.92 in the validation study and 1.00 in the development study.
CONCLUSIONS: This clinical prediction model for 90-day VTE risk following THA and TKA performed well in both development and validation data. This model can be used to estimate an individual\'s risk for VTE following THA/TKA.
摘要：
背景：全髋关节置换术（THA）和全膝关节置换术（TKA）后静脉血栓栓塞（VTE）的风险为1.0％至1.5％，尽管统一的血栓预防。
目的：建立并验证90天VTE风险预测模型。
方法：进行了一项跨国队列研究。对于模型开发，记录来自牛津皇家全科医师学院研究和监测中心,与医院事件统计和英国国家统计局常规数据相关.对于外部验证，数据来自丹麦髋关节和膝关节置换术登记处，全国患者登记处,和国家处方登记处.使用二元多变量逻辑回归技术进行开发。
结果：在英国数据集中，进行了64032次THA/TKA手术，1.4%的患者出现VTE。预测模型包括年龄，身体质量指数,性别,膀胱炎在手术前1年内，静脉炎病史,VTE的历史，静脉曲张的存在，哮喘的存在，短暂性脑缺血发作史，心肌梗死病史,存在高血压和THA或TKA。模型曲线下面积为0.65(95%CI,0.63-0.67)。此外，在丹麦队列中进行了36169例手术，其中1.0%患有VTE。这里,曲线下面积为0.64(95%CI,0.61~0.67).在验证研究中校准斜率为0.92,在开发研究中为1.00。
结论：这种THA和TKA后90天VTE风险的临床预测模型在开发和验证数据中均表现良好。该模型可用于估计THA/TKA后个体的VTE风险。
目的：建立并验证90天VTE风险预测模型。
方法：进行了一项跨国队列研究。对于模型开发，记录来自牛津皇家全科医师学院研究和监测中心,与医院事件统计和英国国家统计局常规数据相关.对于外部验证，数据来自丹麦髋关节和膝关节置换术登记处，全国患者登记处,和国家处方登记处.使用二元多变量逻辑回归技术进行开发。
结果：在英国数据集中，进行了64032次THA/TKA手术，1.4%的患者出现VTE。预测模型包括年龄，身体质量指数,性别,膀胱炎在手术前1年内，静脉炎病史,VTE的历史，静脉曲张的存在，哮喘的存在，短暂性脑缺血发作史，心肌梗死病史,存在高血压和THA或TKA。模型曲线下面积为0.65(95%CI,0.63-0.67)。此外，在丹麦队列中进行了36169例手术，其中1.0%患有VTE。这里,曲线下面积为0.64(95%CI,0.61~0.67).在验证研究中校准斜率为0.92,在开发研究中为1.00。
结论：这种THA和TKA后90天VTE风险的临床预测模型在开发和验证数据中均表现良好。该模型可用于估计THA/TKA后个体的VTE风险。
