一个新的评分系统,以确定心脏门置换后的血栓栓塞风险
Eric G Butchart1, Adrian Ionescu, Nicola Payne
1Department of Cardiothoracic Surgery, University Hospital of Wales, Heath Park, Cardiff, CF14 4XW, UK. egbutchart@aol.com.
Circulation
|September 13, 2003
概括
炎症和血液学标志物,以及临床因素,可以预测门置换 (VR) 患者的血栓栓塞 (TE) 风险. 使用这些预测因素的评分系统可以指导治疗决策.
科学领域:
- 心血管医学 心血管医学
- 血液学 血液学 血液学
- 传染性疾病 传染性疾病
背景情况:
- 血栓塞栓症 (TE) 是一个显著的风险,在门置换 (VR).
- 准确的手术前风险分层对于患者管理至关重要.
- 需要识别传统临床因素之外的可靠预测因素.
研究的目的:
- 确定VR患者中TE的主要炎症和血液学预测因子.
- 开发一个评分系统,用于TE的手术前风险分析.
- 为了告知假肢选择和抗血栓管理策略.
主要方法:
- 在370名VR患者中对临床,心声学,血液学和微生物学参数进行前性检查.
- 多变量分析以确定TE事件的预测因子,平均随访时间为4.4年.
- 开发基于已识别的风险因素的增值评分系统.
主要成果:
- 大动脉置换 (AVR) 后的TE预测因素包括冠状病毒肺炎 (CP) 感染,之前的TE,升高的乙素,癌症史,术后感染,高血压,CABG和糖尿病.
- 额头置换 (MVR) /DVR后TE的预测因素包括平均血小板体积升高,VII因子升高,CP感染,之前的额头切除术,纤维素素升高和网状细胞升高.
- 附加分数系统根据存在的风险因素数量准确预测了TE风险.
结论:
- 精选的血液测试和临床因素有效预测VR患者的TE风险.
- 开发好的评分系统可以帮助进行手术前风险评估.
- 这些发现可以指导假肢选择和抗血栓治疗.
相关概念视频
Imaging Studies for Cardiovascular System VI: Calcium -Scoring CT
976
Calcium-Scoring CT ScanA calcium-scoring CT scan, also known as coronary artery calcium (CAC) scan, detects calcium deposits in the coronary arteries. This test assesses the risk of coronary artery disease (CAD), which can lead to cardiovascular events such as angina, heart failure, and sudden cardiac arrest.A calcium-scoring CT scan is generally recommended for individuals at intermediate risk of CAD without symptoms. It includes:Men aged 40-75 and women aged 50-75: Especially those with a...
976
Mitral Valve Prolapse II: Assessment and Management
1.4K
IntroductionA range of clinical features characterizes Mitral Valve Prolapse (MVP), but it is important to note that many individuals with MVP are asymptomatic and may remain so throughout their lives. For those who do exhibit symptoms, the following are the key clinical features:Palpitations: This is a common symptom where individuals feel an irregular or rapid heartbeat. Palpitations in MVP are often due to arrhythmias such as premature ventricular contractions or supraventricular...
1.4K
Venous Thrombosis I: Introduction
831
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...
831
Venous Thrombosis II: Clinical Manifestations and Diagnostic Studies
470
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...
470
Venous Thrombosis III: Interprofessional Care
482
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...
482
Venous Thrombosis IV: Nursing Management
418
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,...
418


