静脉血栓塞栓症 化学预防 大型癌症手术后的坚持率
Charles D Logan1,2,3, Matthew T Hudnall4, Cary Jo R Schlick1
1Northwestern Quality Improvement, Research, & Education in Surgery, Department of Surgery, Northwestern University, Feinberg School of Medicine, Chicago, Illinois.
JAMA network open
|September 28, 2023
概括
在VHA的癌症手术后,静脉血栓栓塞 (VTE) 的发生率很低. 住院VTE化疗预防的处方率很高,而出院后的处方率与非VHA系统相似,但有一些特殊变化.
科学领域:
- 医学研究 医学研究
- 公共卫生 公共卫生
- 手术瘤学手术瘤学
背景情况:
- 静脉血栓栓塞 (VTE) 是癌症手术后可预防死亡的重要原因.
- 记录了VTE化学预防处方的变化,但VHA的性能尚不清楚.
研究的目的:
- 评估退伍军人事务 (VHA) 癌症手术患者的静脉瘤发作率和化疗预防的坚持.
- 为了比较住院和医院出院后的VTE预防策略.
主要方法:
- 从2015年到2022年,对超过3万名接受癌症手术 (一般,胸部,泌尿器科) 的退伍军人进行了回顾性队列研究.
- 利用VHA数据库来识别患者,跟踪静脉瘤事件和化疗预防的订单.
- 分析了住院和出院后化疗预防的坚持率和静脉瘤发病率.
主要成果:
- 整体术后静脉瘤发作率为1.3% (0.7%住院患者,0.6%出院后).
- 住院化疗预防的订购率很高 (80.4%),按外科专业有显著差异 (98.1%的整体外科 vs. 67.1%的泌尿器科).
- 出院后的化学预防治疗给了10.5%的患者,具有显著的专业差异.
结论:
- 在VHA中,癌症手术后的VTE发病率很低.
- 住院VTE化疗预防率很高,但出院后的处方有所不同,并反映了非VHA系统.
- 在化疗预防中观察到的变化可能是由于整体VTE风险较低而合理的.
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