抗血栓剂的遵守对外科手术期间发病率和死亡率的影响
Olivier Duranteau1,2, Ayoub Hamriti3, Brigitte Ickx3
1Anesthesiology Service, CUB-ULB Hôpital Erasme, Brussels, Belgium. olivier.duranteau@gmail.com.
Journal of anesthesia, analgesia and critical care
|October 18, 2023
概括
对手术进行抗血栓药物调整至关重要. 这项研究发现,不遵守GIHP指南与患者发病率或死亡率结果之间没有显著的联系.
科学领域:
- 医学研究 医学研究
- 临床实践指南 临床实践指南
- 患者安全 患者安全
背景情况:
- 对接受选择性手术的患者来说,对抗血栓药物的管理至关重要.
- 已发表的建议,比如来自Groupeement d'Intérêt pour l'hémostase Peri-opératoire (GIHP) 的建议,指导治疗调整.
- 不遵守这些指导方针可能会影响患者的治疗结果.
研究的目的:
- 评估不遵守GIHP建议对患者发病率和死亡率的影响.
- 评估在服用抗血栓剂的患者中遵循指南和手术结果之间的关系.
主要方法:
- 在学术医院进行了长达7个月的前性,观察性,单心的队列研究.
- 包括589名接受抗血栓剂治疗的患者,计划接受选择性非心脏手术.
- 主要终点:手术后1个月的发病率和死亡率,根据GIHP指南进行评估.
主要成果:
- 发病率为14.8%,有8人死于出血事件,3人死于缺血事件.
- 62%的患者符合GIHP的指导方针.
- 在GIHP指南的遵守和发病率 (p=0.923),1个月生存率 (p=0.698),出血或住院之间没有发现统计学意义上的关联.
结论:
- 这项研究没有发现不严格遵守GIHP建议和患者结果之间的显著关联.
- 评估结果包括发病率,死亡率,出血事件和住院时间.
- 由于研究的局限性,研究结果应谨慎解释,这需要进一步调查.
相关概念视频
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
01:23Peripheral Artery Disease V: Postoperative Nursing Management
12
During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
12
01:20Antiplatelet Drugs: Prostaglandin Synthesis, P2Y12 and Glycoprotein IIb/IIIa Inhibitors
537
Antiplatelet drugs emerge as frontline defenders against the insidious threat of thromboembolic diseases, where abnormal clots obstruct vital blood vessels. These drugs stand as bulwarks, inhibiting platelet aggregation and clot formation, thereby mitigating the risk of life-threatening conditions like myocardial infarction, coronary artery disease, and thrombotic strokes.
Prostaglandin synthesis inhibitors, exemplified by the widely known aspirin, wield their power by irreversibly acetylating...
Prostaglandin synthesis inhibitors, exemplified by the widely known aspirin, wield their power by irreversibly acetylating...
537
01:30Anticoagulant Drugs: Low-Molecular-Weight Heparins
723
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...
723
01:22Aneurysm IV: Nursing Management
8
Vigilant monitoring for aneurysm rupture is essential for patients undergoing aortic surgery.Preoperative Nursing ManagementContinuously monitor the patient for manifestations of aneurysm rupture, such as pallor, weakness, tachycardia, hypotension, abdominal, back, groin, or periumbilical pain, changes in consciousness, and a pulsating abdominal mass. Regularly assess the patient's peripheral pulses.Instruct the patient to consume a clear liquid diet the day before surgery and administer...
8
01:18Anticoagulant Drugs: Vitamin K Antagonists and Direct Oral Anticoagulants
1.2K
Oral anticoagulants are vital tools in preventing and treating blood clotting disorders. This diverse class of medications can be categorized as vitamin K antagonists, exemplified by warfarin, and direct thrombin inhibitors (DTIs), such as dabigatran, as well as factor Xa inhibitors, including rivaroxaban.
Warfarin, a prominent vitamin K antagonist family member, exerts its effect by inhibiting the enzyme VKORC1 (vitamin K epoxide reductase complex 1). By hindering this enzyme, warfarin...
Warfarin, a prominent vitamin K antagonist family member, exerts its effect by inhibiting the enzyme VKORC1 (vitamin K epoxide reductase complex 1). By hindering this enzyme, warfarin...
1.2K