癌症门诊患者的初级血栓预防 - - 现实世界的证据
Joana Liz-Pimenta1,2, Valéria Tavares2,3,4, João Gramaça5
1Department of Medical Oncology, Hospital Center of Trás-Os-Montes E Alto Douro, 5000-508, Vila Real, Portugal.
Journal of thrombosis and thrombolysis
|April 20, 2024
概括
初级血栓预防对于中高风险的静脉血栓塞栓症 (VTE) 癌症门诊患者是安全有效的. 这项葡萄牙实践证据研究支持改善了癌症相关血栓瘤 (CAT) 的预防策略.
科学领域:
- 在瘤学瘤学.
- 血液学 血液学 血液学
- 临床药房 临床药房
背景情况:
- 癌症相关血栓形成 (CAT) 显著增加癌症患者的死亡率.
- 目前的指导方针建议在高风险的门诊患者中进行静脉血栓塞栓症 (VTE) 的初级血栓预防,但证据仍在争论中.
- 葡萄牙缺乏有关癌症门诊患者初级血栓预防的现实证据 (RWE).
研究的目的:
- 调查葡萄牙癌症门诊患者的初级血栓预防实践.
- 在现实环境中评估初级血栓预防的安全性和有效性.
- 在接受预防的癌症患者中确定与VTE发生相关的因素.
主要方法:
- 这是一项为期五年的,多中心的,在八个葡萄牙机构进行的观察性研究.
- 招募了124名接受初级VTE血栓预防治疗的成人癌症门诊患者.
- 终点包括CAT,出血,癌症进展和死亡.
主要成果:
- 高血栓形成风险的癌症 (胰腺,胃) 是普遍存在的 (57%).
- 低分子量肝素 (LMWH) 在55%的患者中使用.
- 在患者中,VTE发生在11%的患者中,严重出血发生在2%的患者中. 血管压缩,升高的D-二次体和以前的VTE与VTE有关.
- 奥科科特夫模型是最好的风险评估工具 (p=0.007).
- 与非CAT患者相比,CAT患者的无进展生存率较低 (p=0.021),但总生存率相似 (p=0.542).
结论:
- 初级血栓预防是中高风险癌症门诊患者在现实环境中安全有效的策略.
- 这项研究提供了葡萄牙第一个关于癌症患者初级血栓预防的RWE.
- 这些发现支持完善预防策略,以减少VTE并改善这一群体的结果.
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