Padua和Caprini评分对AECOPD房颤患者静脉血栓栓塞的预测价值有限。
Limited predictive value of Padua and Caprini scores for venous thromboembolism in AECOPD patients with atrial fibrillation.
摘要(中文译文)
慢性阻塞性肺疾病急性加重期（AECOPD）的静脉血栓栓塞症（VTE）风险升高，尤其是伴有房颤（AF）。然而，在外科或普通医学人群中验证的Caprini和Padua评分可能无法捕捉AECOPD-AF患者的血栓形成风险，其在该亚组中的预测性能尚不清楚。在这项多中心前瞻性队列研究中，我们分析了来自中国十家三级医院的13108名AECOPD患者（包括755名房颤患者和12353名非房颤患者）。根据年龄、性别、吸烟状况、高血压、中风和慢性肾功能不全进行倾向评分匹配（1:4比）。采用多变量逻辑回归评估VTE危险因素，并通过受试者操作特征分析评估Caprini和Padua评分的判别性能。房颤独立增加VTE风险（调整后的OR 1.55，95%CI 1.03-2.33）。这两个评分都显示了次优的辨别力（Caprini AUC 0.616；Padua AUC 0.593），没有显著差异（DeLong的P = 0.349). AECOPD-AF患者表现出更高的VTE事件（72/755，9.5%对150/3020，5.0%，P < 0.001). 在AECOPD-AF人群中，房颤是VTE的独立危险因素。然而，Caprini和Padua评分在该亚组中的预测价值有限，强调了需要专门为AECOPD-AF患者设计的定制风险评估工具。试验注册：中国临床试验注册中心，ChiCTR2100044625。
Abstract
Venous thromboembolism (VTE) risk is elevated in acute exacerbations of COPD (AECOPD), especially with coexisting atrial fibrillation (AF). However, the Caprini and Padua scores, validated in surgical or general medical populations, may not capture thrombotic risk in AECOPD-AF patients, and their predictive performance in this subgroup remains unclear. In this multicenter prospective cohort study, we analyzed 13,108 AECOPD patients (including 755 with AF and 12,353 without AF) from ten tertiary hospitals in China. Propensity score matching (1:4 ratio) was performed based on age, gender, smoking status, hypertension, stroke, and chronic renal insufficiency. Multivariable logistic regression was used to assess VTE risk factors, and the discriminatory performance of the Caprini and Padua scores was evaluated through receiver operating characteristic analysis. AF independently increased VTE risk (adjusted OR 1.55, 95% CI 1.03-2.33). Both scores showed suboptimal discrimination (Caprini AUC 0.616; Padua AUC 0.593), with no significant difference (DeLong's P = 0.349). AECOPD-AF patients exhibited higher VTE events (72/755, 9.5% vs. 150/3020, 5.0%, P < 0.001). AF constitutes an independent risk factor for VTE in the AECOPD-AF population. However, the Caprini and Padua scores show limited predictive value in this subgroup, underscoring the need for a tailored risk assessment tool specifically designed for AECOPD-AF patients.Trial registration: Chinese clinical trial registry, ChiCTR2100044625.
如何引用
AMA
Jiaqi Pu, Yuanming Luo, Hailong Wei, Huiqing Ge, Huiguo Liu, Jianchu Zhang, et al. Limited predictive value of Padua and Caprini scores for venous thromboembolism in AECOPD patients with atrial fibrillation.. Scientific reports. 2026; doi:10.1038/s41598-026-49751-1.
APA
Jiaqi Pu, Yuanming Luo, Hailong Wei, Huiqing Ge, Huiguo Liu, Jianchu Zhang, et al (2026). Limited predictive value of Padua and Caprini scores for venous thromboembolism in AECOPD patients with atrial fibrillation.. Scientific reports. https://doi.org/10.1038/s41598-026-49751-1
GB/T 7714
Jiaqi Pu, Yuanming Luo, Hailong Wei, Huiqing Ge, Huiguo Liu, Jianchu Zhang, et al. Limited predictive value of Padua and Caprini scores for venous thromboembolism in AECOPD patients with atrial fibrillation.[J]. Scientific reports, 2026 doi:10.1038/s41598-026-49751-1.
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