手術前の患者における深部静脈血栓症の診断のための新しい検査前確率スコア

Material type: 博士論文

Author: 濱元, 裕喜

Publisher: Elsevier

Publication date: -

Material Format: Digital

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Name of awarding university/degree: 鹿児島大学,博士(医学),Doctor of Philosophy in Medical Science

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Note (General)：: 博士論文全文, 博士論文要旨, 最終試験結果の要旨, 論文審査の要旨Background: Venous thromboembolism is a serious perioperative complication. We developed a new pre-test probability ...

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Material Type: 博士論文
Title: 手術前の患者における深部静脈血栓症の診断のための新しい検査前確率スコア
Author/Editor: 濱元, 裕喜
Author Heading: 濱元, 裕喜ハマモト, ユウキ
Publication, Distribution, etc.: Elsevier
Alternative Title: A new pre-test probability score for diagnosis of deep vein thrombosis in patients before surgery
Degree grantor/type: 鹿児島大学
Date Granted: 2022-03-11
Dissertation Number: 甲総研第652号
Degree Type: 博士(医学)
Doctor of Philosophy in Medical Science
Text Language Code: eng
Subject Heading: Before surgery
D-dimer
Deep vein thrombosis
Kagoshima-DVT score
Pre-test probability score
Whole leg ultrasonography
Target Audience: 一般
Note (General): 博士論文全文, 博士論文要旨, 最終試験結果の要旨, 論文審査の要旨
Background: Venous thromboembolism is a serious perioperative complication. We developed a new pre-test probability score for predicting deep vein thrombosis (DVT) before surgery. Methods: Whole leg ultrasonography was performed on 973 inpatients and outpatients with suspected DVT based on a preoperative D-dimer cut-off value of ≥ 1 μg/ml. We allocated two-thirds (n = 651) of the study participants to a derivation cohort and one-third (n = 322) to a validation cohort. The pre-test probability model was developed from the derivation cohort data. Results: The pre-test probability model for DVT assigned 2 points to D-dimer ≥ 1.5 μg/mL and 1 point each to age ≥ 60 years, female sex, ongoing glucocorticoid therapy, prolonged immobility, and cancer with high risk of DVT. The area under the curve of the pre-test probability score was 0.72 and 0.70 in the derivation and validation cohorts, respectively. The rates of DVT according to pre-test probability scores in the derivation and validation cohorts were 7% and 6% in the low (score = 0-2), 23% and 22% in the intermediate (score = 3-4), and 47% and 50% in the high probability group (score ≥ 5), respectively (p < 0.0001). Conclusions: The pre-test probability score (Kagoshima-DVT score) was helpful in detecting preoperative DVT in both inpatients and outpatients. We identified low probability group to reduce whole-leg ultrasonography and high probability group to detect more DVT before surgery. Yuki Hamamoto, Akihiro Tokushige, Yuasa Toshinori, Yoshiyuki Ikeda, Yoshihisa Horizoe, Hisayo Yasuda, Takuro Kubozono, Mitsuru Ohishi A new pre-test probability score for diagnosis of deep vein thrombosis in patients before surgery Journal of Cardiology 79 (2022) 664–670
Format (IMT): application/pdf
Source: Diss_濱元_裕喜_ISK652_2021 （fulltext）
https://ir.kagoshima-u.ac.jp/record/16105/files/Diss_%E6%BF%B1%E5%85%83_%E8%A3%95%E5%96%9C_ISK652_2021.pdf
Access Restrictions: インターネット公開
Data Provider (Database): 国立情報学研究所 : 学術機関リポジトリデータベース（IRDB）（機関リポジトリ）
https://irdb.nii.ac.jp
Original Data Provider (Database): 鹿児島大学 : 鹿児島大学リポジトリ