在接受重大腹部癌症手术的患者中,持续使用延长静脉血栓塞栓症预防
Joshua N Herb1, Yoshiko Iwai2, Lisette N Dunham3
1Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Journal of surgical oncology
|October 6, 2023
概括
在老年癌症患者中,延伸静脉血栓塞栓症 (VTE) 预防的坚持是低的. 预防组中更高的VTE率表明,一些患者接受了治疗性抗凝药,而不仅仅是预防.
科学领域:
- 在瘤学瘤学.
- 血管外科 血管外科
- 老年医学 老年医学
背景情况:
- 指导方针建议在经过重大腹部癌症手术后,对高风险患者进行延长静脉血栓栓塞 (VTE) 预防.
- 医疗保险人口中,老年人和风险较高的人群,对延长VTE预防使用的数据有限.
研究的目的:
- 评估接受重大腹部癌症手术的老年患者在出院时延长VTE预防处方的比例.
- 在这个人群中评估出院后的VTE和出血事件的发生率.
主要方法:
- 对2012-2017年期间20%的医疗保险索赔随机样本进行了回顾性分析.
- 纳入标准:65岁以上的腹部癌症患者接受切除.
- 主要结局:接受延长VTE预防的比例;次要结局:离院后的VTE和出血事件.
主要成果:
- 在72,983名患者中,8.9%接受了延长的静脉瘤预防,从2012年 (7.2%) 到2017年 (10.6%) 显著增加.
- 出院后出血的发生率是预防后的1.0%,而没有预防后的0.8%.
- 出院后静脉瘤发病率为5.2%,使用预防措施,而未使用预防措施为2.4%.
结论:
- 在接受重大腹部癌症手术的老年患者中,遵守推的延长VTE预防是很低的.
- 预防组中较高的VTE率可能表明包括治疗性抗凝剂,可能低估了实际的血栓预防率.
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