在全膝关节整形术后深静脉血栓症预防的趋势:2016年至2021年
Jeremy A Dubin1, Sandeep S Bains1, Daniel Hameed1
1LifeBridge Health, Sinai Hospital of Baltimore, Rubin Institute for Advanced Orthopedics, Baltimore, Maryland.
The Journal of arthroplasty
|February 7, 2024
概括
在全膝关节整形术 (TKA) 后,用于静脉血栓栓塞 (VTE) 预防的阿司匹林使用在2016-2021年期间显著增加. 华法林使用与更高的VTE率有关,而阿司匹林显示出最低的并发症率.
科学领域:
- 整形外科手术 整形外科手术
- 药理学 药理学是指药理学的学科.
- 流行病学 流行病学
背景情况:
- 美国骨科外科医生学会在2011年推静脉血栓栓塞 (VTE) 预防全膝关节整形术 (TKA) 后.
- 在TKA后的VTE预防策略已经发展,需要分析当前的趋势和结果.
研究的目的:
- 为了检查术后并发症率 (PE,DVT,输血) 与不同的VTE预防药物TKA后.
- 分析2016年至2021年间使用VTE预防的趋势.
- 根据VTE预防类型,根据TKA后90天发生并发症的独立风险因素.
主要方法:
- 从2016年至2021年,利用了一个全国性,全付款人数据库,包括接受初级TKA的患者.
- 排除了先前有抗凝血,高凝血状态或癌症的患者.
- 进行多变量回归以确定90天VTE预防队列 (阿司匹林,埃诺沙巴林,里瓦罗克萨班,华法林) 的总并发症的独立风险因素.
主要成果:
- 阿司匹林是最常用的药物 (62,054名患者),其使用率从32.1%增加到70.8% (2016-2021年).
- 华法林使用量从19.3%下降到3.0%,并且与最高的PE (1.8%) 和DVT (5.7%) 率有关.
- 阿司匹林使用与最低的PE (0.6%) 和DVT (1.6%) 率相关. 埃诺沙巴林,里瓦罗克萨班和华法林是90天并发症的独立危险因素.
结论:
- 流行病学分析显示,从2016年到2021年,在全国范围内,在TKA后的VTE预防中使用阿司匹林的数量显著增加.
- 与其他药物相比,这种转向阿司匹林的转变与较低的VTE发病率相关.
- 了解这些抗凝血趋势对于优化TKA后患者护理至关重要.
相关概念视频
Anticoagulant 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
Anticoagulant Drugs: Low-Molecular-Weight Heparins
698
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...
698
Overview of Systemic Veins
469
Systemic veins are crucial blood vessels that return deoxygenated blood from various body tissues back to the heart. There are three systemic veins that return deoxygenated blood to the heart, they are as follows.
The coronary sinus, the heart's principal vein, resides in the coronary sulcus on the heart's posterior aspect. This broad venous channel receives nearly all venous blood from the myocardium, the heart muscle. It is fed by three primary veins: the great cardiac vein, the...
The coronary sinus, the heart's principal vein, resides in the coronary sulcus on the heart's posterior aspect. This broad venous channel receives nearly all venous blood from the myocardium, the heart muscle. It is fed by three primary veins: the great cardiac vein, the...
469
Antiplatelet Drugs: Prostaglandin Synthesis, P2Y12 and Glycoprotein IIb/IIIa Inhibitors
525
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...
525
Disorders of Hemostasis
915
Hemostasis, the process that stops bleeding after a blood vessel injury, is crucial for maintaining the integrity of the circulatory system. However, disorders of hemostasis can disrupt this delicate balance, leading to either excessive clotting or bleeding. These disorders can be broadly classified into thromboembolic disorders and bleeding disorders.
Thromboembolic Disorders
Two factors primarily cause thromboembolic conditions.
Thromboembolic Disorders
Two factors primarily cause thromboembolic conditions.
915
Veins of Lower Limbs
836
The human body consists of an intricate network of veins responsible for the crucial task of blood drainage from the lower limbs. These veins can be categorized into two main types: deep veins and superficial veins.
Formed by the union of the medial and lateral plantar veins, the posterior tibial vein, rising through the calf muscle, assimilates the fibular vein. The anterior tibial vein, a superior extension of the foot's dorsalis pedis vein, merges with the posterior tibial vein at the...
Formed by the union of the medial and lateral plantar veins, the posterior tibial vein, rising through the calf muscle, assimilates the fibular vein. The anterior tibial vein, a superior extension of the foot's dorsalis pedis vein, merges with the posterior tibial vein at the...
836


