在加菲尔德-VTE注册表中比较美国和加拿大的静脉血栓栓塞结局治疗模式
Adrian C Chen1, Amit S Rao2, Alisha Oropallo2
1Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA; Department of Vascular Surgery, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA.
Thrombosis research
|November 17, 2023
概括
与加拿大患者相比,美国静脉血栓塞栓症 (VTE) 患者的死亡率,住院和出血率较高. 风险概况,护理和治疗策略的差异可能解释这些不良结果.
科学领域:
- 心血管医学 心血管医学
- 流行病学 流行病学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 静脉血栓塞栓症 (VTE) 是发达国家发病率和死亡率的重要原因.
- 了解VTE管理和结果的国际差异对于改善患者护理至关重要.
研究的目的:
- 为了比较美国和加拿大的VTE管理中的基线风险概况和患者工作流程模式.
- 确定导致美国和加拿大的VTE结果差异的因素.
主要方法:
- 在美国和加拿大的FIELD (GARFIELD-VTE) 研究中分析了全球抗凝剂注册表中的1101名患者 (2014-2017年).
- 预期,观察性,多中心注册表,跟踪患者3年.
- 基线特征,治疗策略和不良结果的比较.
主要成果:
- 美国患者的VTE风险概况较高,包括固定和最近的手术.
- 美国患者 (23.0%) 与加拿大患者 (39.2%) 相比,直接口服抗凝剂 (DOAC) 的使用频率较低.
- 经过调整后的分析显示,51.9%的全因死亡风险更高,随着增加住院治疗,严重出血和美国患者在3年后的复发性静脉瘤.
结论:
- 在美国,较高的不良VTE结局率可能与不同的基线风险概况有关.
- 医疗机构护理和医疗专家的分配/策略的差异可能会导致结果差异.
- 国际比较强调需要优化VTE管理策略.
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