血栓生成与静脉血栓栓塞的复发有关,但与老年人严重出血和死亡无关:一个前性的多中心队列研究
Kristina Vrotniakaite-Bajerciene1,2, Sereina Rütsche1,2, Sara Calzavarini1,2
1Department of Hematology and Central Hematology Laboratory, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland.
Journal of clinical medicine
|September 28, 2023
概括
血生成预测治疗后老年患者的静脉血栓栓塞 (VTE) 复发. 这种血液检查可能有助于识别年龄较大的个人在抗凝后风险更高的VTE复发.
科学领域:
- 血液学 血液学 血液学
- 老年医学 老年医学
- 心血管研究研究心血管研究
背景情况:
- 血栓生成与静脉血栓栓塞 (VTE) 复发,严重出血和老年患者的死亡率等临床结果之间的关联仍然不清楚.
- 老年人代表着受VTE影响的重要人口,需要更好的风险分层工具.
研究的目的:
- 为了前性地研究血栓生成与VTE复发风险,严重出血和65岁及以上急性VTE患者的死亡率之间的关系.
- 评估血栓生成测量对老年人VTE后不良事件的预测价值.
主要方法:
- 一项前性队列研究跟踪551名连续患者,年龄≥65岁,患有急性VTE,持续2年,血栓生成评估为1年后的VTE指数.
- 结果包括VTE复发,严重出血和死亡率. 分析了血栓生成参数,包括峰值比率和正常化峰值比率 (含/不含血栓模块素).
- 统计分析涉及调整的细分危险比率来评估关联,特别是在非抗凝血患者中.
主要成果:
- 血栓激素生成是非抗凝血老年患者静脉瘤复发的重要预测因子.
- 特定标志物,峰值比率和正常化峰值比率,与静脉瘤复发相关 (调整后的次危险比率分别为4.09和2.18),但与严重出血或死亡率无关.
- 在整体老年人队列中,血栓生成与静脉瘤复发有关,独立于重大出血和死亡率.
结论:
- 血栓生成测量显示,在完成抗凝治疗后,识别高风险的VTE复发的老年患者具有潜在的实用性.
- 这种测试可以帮助个性化风险评估和老年人群中VTE的管理策略.
- 需要进一步的研究来证实这些发现,并将血栓生成测试纳入临床实践指南.
相关概念视频
01:30Venous Thrombosis I: Introduction
12
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...
12
01:29Venous Thrombosis III: Interprofessional Care
10
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...
10
01:20Venous Thrombosis II: Clinical Manifestations and Diagnostic Studies
14
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...
14
01:30Venous Thrombosis IV: Nursing Management
14
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,...
14
01:30Anticoagulant Drugs: Low-Molecular-Weight Heparins
741
Hemostasis is a crucial process that prevents excessive blood loss from damaged blood vessels. It involves various mechanisms such as vasoconstriction, platelet adhesion and activation, and fibrin formation. The importance of each mechanism depends on the type of vessel injury. In contrast, thrombosis is the abnormal formation of a blood clot within the blood vessels, leading to potential complications if the clot obstructs blood flow. Thrombosis can be caused by increased coagulability of the...
741
01:27Pulmonary Embolism III: Nursing Management
15
A pulmonary embolism occurs when a thrombus, amniotic fluid, tumor tissue, fat, or air embolus blocks one or more pulmonary arteries. Effective nursing management and patient education are crucial for improving outcomes and preventing recurrence.Nursing management starts with obtaining a comprehensive patient history, particularly noting any history of deep vein thrombosis (DVT). Assess for clinical manifestations, including dyspnea, chest pain, crackles, heart murmurs, and signs of right-sided...
15