The predictive and diagnostic value of Caprini score combined with D—dimer dynamic monitoring for postoperative deep vein thrombosis formation in patients with severe traumatic brain injury

XU Xueli; XIAO Hua; MU Yanping

Abstract：Objective:This study aimed to explore the predictive and diagnostic value of Caprini score combined with dynamic monitoring of D—dimer(D—D)for postoperative deep vein thrombosis(DVT)in patients with severe traumatic brain injury.Methods:A total of 144 patients with severe traumatic brain injury were enrolled as research subjects and divided into the observation group(51 cases with DVT)and the control group(93 cases without DVT)based on whether DVT occurred postoperatively.D—D level was detected before operation and 1 day,3 days and 7 days after operation,and Caprini score was made.The area under receiver operating characteristic curve(ROC)area under curve(AUC)was used to evaluate the diagnostic value of Caprini score and D—D in the formation of DVT after severe craniocerebral trauma.Results:There was no significant difference in the overall risk distribution of low-risk,medium—risk,high—risk and extremely high—risk between the two groups before operation,1 day after operation and 7 days after operation(P＞0.05),but there was significant difference between the two groups at 3 days after operation(P＜0.05).The proportion of extremely high risk in the preoperative observation group was significantly higher than that in the control group,and the difference was statistically significant(P＜0.05).One day after operation,the proportion of low risk in the observation group was significantly lower than that in the control group,and the proportion of extremely high risk was significantly higher than that in the control group,with statistical significance(P＜0.05).Three days af-ter operation,the proportion of critical patients in the observation group was significantly lower than that in the control group,and the proportion of extremely high—risk patients was significantly higher than that in the control group,with statistical significance(P＜0.05).Seven days after operation,there was no significant difference among all the stratified groups(P＞0.05).The preoperative D—D levels in both groups were normal,and there was no statistical difference between the two groups(P＞0.05).The level of D—D in both groups was higher than that before operation,and reached the highest level at 3 days after operation.The level of D—D in the observation group was higher than 500 μg/L at 3 days after operation,indicating that it was in hypercoagulable state at this time,while the level of D—D in the control group did not reach hypercoagulable state.The level of D—D in the observation group was significantly higher than that in the control group on the 1st,3rd and 7th day after operation,with statistical significance(P＜0.05).The AUC of the combined diagnosis of the two indexes was significantly higher than that of Caprini score and plasma D—D single test,with statistical significance(P＜0.05).Conclusion:Caprini score combined with dynamic monitoring of D—D can assess perioperative coagulation changes in patients with traumatic brain injury,and has effective diagnostic value for postoperative DVT in patients with severe traumatic brain injury in clinical practice.