Aim

Psychiatric patients have increased risk of deep vein thrombosis (DVT). However, there is no systematic data on risk assessment of DVT among psychiatric inpatients. The aim of this study was to develop a risk stratification scoring system for DVT among psychiatic patients on admission.

Methods

A systematic review of psychiatric patient's charts, who were admitted to the Tokyo Metropolitan Matsuzawa Hospital from June 2012 to February 2016 and underwent screening for DVT, was conducted. Patients were randomly divided into development (n = 2634) and validation (n = 2634) groups. Estimated risk values in the multiple logistic regression model for the development sample were rounded to the nearest integer, and used as points of associated factors in the risk stratification scoring system; the total scores were tested in the validation sample. The score's discriminatory ability was assessed with the area under the receiver operating characteristic curve (AUC).

Results

Among the 5268 patients, 258 (4.9%) had DVT. Advancing age, female sex, active cancer, previous venous thromboembolism, transfer from a general hospital, catatonia, and major depressive episode were all significantly associated with the presence of DVT in the development sample. The total score showed good discriminatory ability in the validation sample (AUC: 0.816, 95% confidence interval: 0.781–0.851); scores of 0–1, 2–3, 4–5, and ≥ 6 were associated with very low risk (0.7%), low risk (4.6%), moderate risk (14.9%), and high risk (35%) for DVT, respectively.

Conclusion

Our risk stratification scoring system showed good performance for detection of DVT among psychiatric patients on admission.

中文翻译：

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精神病入院时深静脉血栓形成风险分层评分系统的开发

目的

精神病患者发生深静脉血栓形成 (DVT) 的风险增加。然而，没有关于精神科住院患者 DVT 风险评估的系统数据。本研究的目的是开发入院时精神病患者 DVT 的风险分层评分系统。

方法

对 2012 年 6 月至 2016 年 2 月在东京都松泽医院住院并接受 DVT 筛查的精神病患者的病历进行了系统审查。患者被随机分为发展组 ( n  = 2634) 和验证组 ( n  = 2634)。开发样本的多元逻辑回归模型中的估计风险值四舍五入到最接近的整数，作为风险分层评分系统中相关因素的点数；在验证样本中测试了总分。评分的区分能力用受试者工作特征曲线下面积（AUC）来评估。

结果

在 5268 名患者中，258 名 (4.9%) 患有 DVT。高龄、女性、活动性癌症、既往静脉血栓栓塞、从综合医院转院、紧张症和重度抑郁发作都与发育样本中 DVT 的存在显着相关。总分在验证样本中表现出良好的判别能力（AUC：0.816，95%置信区间：0.781-0.851）；0-1、2-3、4-5 和 ≥ 6 分与极低风险 (0.7%)、低风险 (4.6%)、中度风险 (14.9%) 和高风险 (35%) 相关分别为 DVT。

结论

我们的风险分层评分系统显示出在入院时检测精神病患者 DVT 的良好性能。