Alternative TitleA new pre-test probability score for diagnosis of deep vein thrombosis in patients before surgery
Degree Type博士(医学)
Doctor of Philosophy in Medical Science
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 OhishiA new pre-test probability score for diagnosis of deep vein thrombosis in patients before surgeryJournal of Cardiology 79 (2022) 664–670
Collection (particular)国立国会図書館デジタルコレクション > デジタル化資料 > 博士論文
Date Accepted (W3CDTF)2023-04-07T23:08:39+09:00
Data Provider (Database)国立国会図書館 : 国立国会図書館デジタルコレクション