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结直肠手术后手术后风险因素:卡普里尼得分是否足够?
Anyelin Almanzar1, Sophia L Dahmani2, Sami Shoucair3
1Department of Colorectal Surgery, Medstar Washington Hospital Center, USA.
American journal of surgery
|March 10, 2024
概括
手术后结直肠手术患者有1.75%的静脉血栓栓塞 (VTE) 风险. 紧急的手术,低白蛋白和输血是VTE的关键风险因素,需要改进预防策略.
科学领域:
- 结肠直肠手术 结肠直肠手术
- 血管外科 血管外科
- 血栓形成研究研究
背景情况:
- 手术后结直肠静脉血栓栓塞 (VTE) 的发生率为1-3%.
- 风险评估模型,如修改的卡普里尼,用于预防.
- 没有考虑的危险因素包括低白蛋白,输血,紧急手术和类固醇使用.
研究的目的:
- 在大肠直肠手术患者手术后30天内评估静脉动脉突发症的发生率.
- 为了确定标准模型之外的额外风险因素.
主要方法:
- 多中心,回顾性研究.
- 从2021年1月到2021年12月收集的数据.
- 主要终点:手术后30天VTE率.
主要成果:
- 整体VTE发生率为1.75%.
- 53%的VTE患者进行了紧急/紧急手术;60%接受了术后输血.
- 66%的已知白蛋白水平的患者的白蛋白水平<3.5g/dL;只有30%的患者的卡普里尼分数高.
结论:
- 紧急/突发性手术,手术前低白蛋白和输血是VTE的重要危险因素.
- 这些因素应考虑加强VTE查和预防.
- 目前的风险模型可能无法完全捕捉结直肠外科手术患者的VTE风险.
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