与创伤性脑损伤患者静脉血栓栓塞发作的相关因素
Kyril L Cole1, Sarah Nguyen2, Savannah Gelhard1
1School of Medicine, University of Utah, Salt Lake City, UT, USA.
Neurocritical care
|July 8, 2023
概括
静脉血栓栓塞事件 (VTE) 是创伤性脑损伤 (TBI) 患者的风险. 错过四剂VTE预防药物显著增加了这种风险,突出了改善护理方案的需要.
科学领域:
- 创伤和重症监护医学 创伤和重症监护医学
- 血管外科 血管外科
- 神经学 神经学
背景情况:
- 创伤性脑损伤 (TBI) 诱导前血栓状态,增加了受影响患者静脉血栓栓塞 (VTE) 事件的风险.
- 了解影响静脉瘤发展的人口和临床因素对于创伤和重症监护机构的有效患者管理至关重要.
研究的目的:
- 确定与TBI患者的VTE发展相关的关键人口和临床变量.
- 确定这些变量对接受预防的TBI患者VTE发生率和时间的影响.
主要方法:
- 追溯横截面研究分析了从818名入住一级创伤中心的TBI患者 (2015-2020) 的数据.
- 被纳入的患者正在接受静脉瘤预防;收集了人口统计,临床变量和静脉瘤事件的数据.
主要成果:
- 总体VTE发病率为9.1%,深静脉血栓症 (DVT) 为7.6%,肺栓塞 (PE) 为3.2%.
- 患有静脉动脉瘤的患者年轻,受伤严重 (GCS较低,ISS较高),经历过多重创伤,并且更经常需要神经外科干预.
- 病史上有VTE和错过1剂VTE预防药物与更高的VTE风险有关;具体来说,4-6次错过剂量预测了最高风险 (或4.08).
结论:
- 患者特异性因素,包括遗漏的VTE预防剂量,与TBI患者的VTE发展有显著的关联.
- 四次遗漏的化学预防剂量的门是关键的,可修改的因素,与这种人群的VTE风险增加有关.
- 制定机构协议和利用电子病历工具来最大限度地减少错过的剂量,特别是在接受手术的患者中,可能会降低VTE的发生率.
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