关键词: 神经重症患者, 下肢深静脉血栓, Nomogram模型

Abstract: Objective To investigate the risk factors of deep venous thrombosis of lower extremity in severe neurological patiens and to construct the relevant nomogram prediction model based on this analysis. Methods The relevant clinical data of 75 severe neurological patients admitted to the neurosurgical intensive care unit from January 2019 to March 2022 were analyzed retrospectively.According to the Results of the lower limb color Doppler ultrasound examination,they were divided into thrombotic group and non-thrombotic group.Comparing the related clinical data between the two groups,univariate analysis and multivariate logistic regression analysis were used to determine the risk factors of deep venous thrombosis in these neurosevere patients.In addition,the Nomogram model for the risk prediction of deep venous thrombosis of lower limbs was constructed.The reliability of the prediction model was also evaluated using the receiver operator characteristic curve (ROC). Results The univariate analysis showed:there was not significant difference in the data of gender,history of hypertension,cerebral hernia during the course and platelet count.The age of 65 years,muscle strength of lower limb<3,GCS score≤8,lower limb braking and deep venipuncture and plasma D-dimer> 0.5 mg/L are the factors affecting deep venous thrombosis of lower extremity in severe neurological patients ; Further multivariate logistic regression analysis showed that aged 65 years,muscle strength of lower limb <3,lower limb braking and deep venipuncture and plasma D-dimer> 0.5 mg/L were independent risk factors for deep venous thrombosis of lower extremity in severe neurologic patients.The Nomogram prediction model of lower limb DVT formation was established after the assignment of these risk factors indicators,Its ROC showed AUC=0.831 (95% CI:0.837～0.975,P<0.001),The predictive sensitivity was 82.9%,The predicted specificity was 88.2%. Conclusion The nomogram model of risk prediction of deep venous thrombosis of lower extremity in severe neurological patients is simple,easy to master and has good calibration,which is of great significance for the prediction of DVT,reducing the risk and improving the prognosis of patients in the neuro-critical patients.

Key words: Severe neurological patients, Deep venous thrombosis of lower extremity, Nomogram model