创伤患者的协议驱动静脉血栓栓塞化学预防的结果:创伤质量改善项目分析
Peter N Kyros1, Forest R Sheppard1, Jaswin S Sawhney1
1Division of Acute Care Surgery, Department of Surgery, Maine Medical Center, Portland, ME, USA.
The American surgeon
|June 30, 2023
概括
创伤患者静脉血栓塞栓症 (VTE) 化疗预防的新方案通过引导患者生理学和并发症治疗来减少静脉血栓塞栓症 (VTE) 事件,减少对低分子量肝素 (LMWH) 的依赖.
科学领域:
- 创伤外科手术是什么
- 药理学 药理学是指药理学的学科.
- 关键护理医学 关键护理医学
背景情况:
- 低分子量肝素 (LMWH) 是创伤患者静脉血栓塞栓症 (VTE) 化疗预防的标准.
- 目前的LMWH使用显示出不一致.
- 根据患者生理学和并发性疾病制定了一项指导化疗预防的协议.
研究的目的:
- 根据患者生理学和并发症指导的化疗预防方案来评估静脉瘤结局.
- 为了比较协议引导方法和标准LMWH使用之间的VTE率.
- 评估本协议对LMWH利用的影响.
主要方法:
- 在一级创伤中心对2019年春季至2021年秋季ACS TQIP基准报告的分析.
- 包括"所有患者"和"老年人" (年龄≥55岁) 队列.
- 收集患者人口统计数据,静脉瘤发作率和药物预防的类型.
主要成果:
- 非LMWH化疗预防的使用在单一机构 (SI) 队列 (62.6%所有患者,68.8%老年人) 与所有医院 (AH) (22.1%所有患者,28.1%老年人) 相比显著更高.
- 在所有患者的SI队列中,VTE,DVT和PE的发病率显著降低.
- 老年人亚组显示VTE和DVT率降低,与AH相比,PE率在统计上相当.
结论:
- 协议驱动的VTE化疗预防导致LMWH使用显著降低.
- 观察到所有VTE,DVT和PE的显著减少.
- 遵守协议可能会减少创伤患者的VTE事件,这表明从LMWH作为唯一标准的潜在转变.
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