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在创伤患者群体中,直接口服抗凝剂度的预测因素
Louis Perkins1, Laura Adams1, Dmitri Lerner2
1Department of Surgery, Division of Trauma, Surgical Critical Care, Burns and Acute Care Surgery, University of California San Diego, San Diego, California, USA.
Trauma surgery & acute care open
|January 26, 2024
概括
直接口服抗凝剂 (DOAC) 的水平在创伤患者中有所不同. 年龄较大,体型较小,功能低下的女性的抗Xa水平较高,但与结果没有发现联系.
科学领域:
- 创伤和紧急医疗医学
- 药理学和毒理学 药理学和毒理学
- 临床化学 临床化学
背景情况:
- 直接口服抗凝剂 (DOAC) 越来越多地用于创伤患者.
- 了解该人群中DOAC度对于患者管理至关重要.
- 以前的研究还没有完全阐明创伤后DOAC水平的预测因素和临床意义.
研究的目的:
- 确定创伤患者中亚治疗性和治疗性DOAC度的患病率和预测因素.
- 研究抗Xa (抗Xa) 水平与临床结果 (包括出血和死亡率) 之间的关联.
- 假设较高的抗Xa水平与增加的不良事件相关.
主要方法:
- 创伤患者在1级创伤中心接受阿皮克萨班或里瓦罗克萨班治疗的回顾性队列研究 (2015年1月 - 2021年7月).
- 包括在呈现时测量抗Xa水平的患者;不包括那些没有.
- 定义了治疗范围,并使用线性和逻辑回归来分析抗Xa水平和结果.
主要成果:
- 245名创伤患者的抗Xa水平被测量;39%的治疗水平,20%的超治疗水平.
- 较高的抗Xa水平与女性性别,年龄增加,身材较小和估计肌素清除率较低有关.
- 在抗Xa水平和输血需求,逆转剂使用,内出血或死亡率之间没有发现显著的相关性.
结论:
- 在创伤患者中,DOAC抗Xa水平表现出显著的变化.
- 特定的患者人群 (老年人群,女性,体型较小,功能低下) 与创伤后抗Xa水平较高有关.
- 在此研究中,创伤患者当前的抗Xa水平与不良临床结果无关.
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