再発性血栓形成と,上肢の最初の静脈血栓形成後の生存率
L E Flinterman1, A van Hylckama Vlieg, F R Rosendaal
1Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands.
Circulation
|September 10, 2008
まとめ
最初の上肢静脈動脈栓塞 (UEVT) は,特に女性およびBMIが25以上の人では,再発リスクが高い. UEVT患者の生存率は低下しています.
科学分野:
- 心血管医学 心血管医学
- 血液学 ヘマトロジ
- トロンボシス研究研究
背景:
- 最初の上肢静脈栓塞 (UEVT) の後のアウトカムに関する理解は限られている.
- UEVT患者における発生率,生存率,再発リスク因子に関するデータの必要性.
研究 の 目的:
- 最初のUEVT後に発生率,生存率,再発のリスク要因を調査する.
- UEVTを経験している患者の長期的な予後を評価する.
主な方法:
- 最初のUEVTを受けた224人の患者 (18〜70歳) の前向きのフォローアップ研究.
- 抗凝固薬クリニック,国家死亡記録,医療記録,アンケートなどのデータ収集.
- フォローアップの平均期間は3年でした.
主要な成果:
- 3年間にわたる高頻度の再発 (1000人年あたり43.2人)
- 生存率が著しく低下し,一般人よりも5.4倍高い死亡率を示した.
- 女性 (HR1.8) とBMI>=25kg/mの患者で再発リスクの増加が観察されました.
- 初期血栓形成における中枢静脈カテーテルの使用は,再発リスクの減少と関連しています.
- Nonsubclavian thrombosisは再発リスクが増加したが,プロトロンブティック変異はそうではなかった.
結論:
- 最初のUEVTは,生命的予後が悪く,再発リスクが高くなります.
- 再発の主な危険因子には,女性の性別,BMIの上昇,非鎖骨血栓症が含まれます.
- さらなる研究により,UEVTの標的型予防と管理戦略を策定することができます.
関連する概念動画
Venous Thrombosis I: Introduction
Venous thrombosis, the most common disorder of the veins, involves the formation of a thrombus or blood clot associated with vein inflammation. It can be classified as either superficial vein thrombosis or deep vein thrombosis.Superficial Vein Thrombosis: This involves the formation of a thrombus in a superficial vein, usually the greater or lesser saphenous vein. Though less severe than deep vein thrombosis (DVT), SVT can lead to complications if untreated.Deep Vein Thrombosis (DVT): This...
Venous Thrombosis III: Interprofessional Care
Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
Venous Thrombosis II: Clinical Manifestations and Diagnostic Studies
The key difference between Superficial Vein Thrombosis (SVT) and Deep Vein Thrombosis (DVT) lies in their location and severity.Clinical ManifestationsSVT typically presents with localized pain, tenderness, and redness along the course of a superficial vein, often accompanied by a palpable, cord-like structure under the skin. This condition is usually less dangerous than DVT but can be uncomfortable and may lead to complications such as cellulitis or, rarely, a clot extension into the deep...
Venous Thrombosis IV: Nursing Management
Nursing management begins with a thorough assessment of the patient's health history. Key factors include trauma to veins, peripherally inserted central catheters, varicose veins, recent pregnancy or childbirth, surgery, bacteremia, prolonged bed rest, atrial fibrillation, COPD, heart failure, cancer, coagulation disorders, myocardial infarction, spinal cord injury, stroke, prolonged travel, recent bone fractures, and dehydration. Review medication intake, particularly oral contraceptives,...
Peripheral Artery Disease V: Postoperative Nursing Management
During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
Varicose Veins II: Diagnostic Studies and Interprofessional Care
Varicose veins, or varicosities, develop when the valves in the veins, which control blood flow, weaken or damage. It causes blood to pool and the veins to enlarge. Understanding the clinical manifestations, diagnostic approaches, and management options for varicose veins is crucial for effective treatment and relief.Clinical manifestationsClinical manifestations of varicose veins include a heavy, achy feeling or pain after prolonged standing or sitting. This discomfort can often be relieved by...
