风险分层的静脉血栓塞栓症预防在低血压患者使用卡普里尼评估:实践模式和改进的机会
Michael A Edwards1, Aaron Spaulding2, Emily Brennan3
1Department of Surgery, Mayo Clinic, Jacksonville, Florida.
概括
实施基于Caprini指导方针的风险分层静脉血栓塞栓症 (VTE) 预防在减肥手术患者中是安全有效的. 适当的预防可以减少VTE事件而不会增加出血并发症.
科学领域:
- 外科手术 手术手术
- 血管医学 血管医学
- 患者安全 患者安全
背景情况:
- 静脉血栓塞栓症 (VTE) 是一种罕见但显著的死亡原因,在减肥手术后死亡.
- 目前对VTE风险分层工具的使用情况以及对该患者群体的实践指南的遵守情况尚未确定.
研究的目的:
- 评估在减肥手术患者中使用风险分层VTE预防的使用情况.
- 评估VTE预防对VTE和出血结果的影响.
主要方法:
- 从2016年到2021年,对1849例减肥手术病例 (Roux-en-Y胃绕道和袖子胃切除术) 的回顾性分析.
- 确定卡普里尼分数和VTE预防方案;根据指南评估预防的适当性.
- 在使用统计测试的预防队伍之间对VTE和出血结果进行比较.
主要成果:
- 70%的患者接受了适当的住院VTE预防,而只有3.7%接受了适当的出院预防.
- 在没有适当预防的患者中观察到更高的平均卡普里尼得分 (8.45比8.04).
- 所有排泄VTE事件发生在未接受适当预防的患者中;适当预防没有增加出血风险.
结论:
- 根据卡普里尼指导方针,可以安全地给低体重手术患者提供VTE预防.
- 适当的VTE预防可以减少可预防的VTE并发症.
- 遵守VTE预防指南似乎不会增加这一队列的出血风险.
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