在静脉血栓塞栓症风险分层中,初步临床运动评估的不准确性
Erik H Hoyer1, Aditya Bhave2, Wingel Xue2
1Department of Physical Medicine and Rehabilitation, The Johns Hopkins University School of Medicine, Baltimore, Md; Department of Internal Medicine, School of Medicine, The Johns Hopkins University School of Medicine, Baltimore, Md; Armstrong Institute for Patient Safety and Quality, Johns Hopkins Medicine, Baltimore, Md.
The American journal of medicine
|April 22, 2024
概括
使用约翰霍普金斯-最高水平的移动性 (JH-HLM) 工具的客观移动性评估可以改善入院患者的静脉血栓塞栓症风险分层. 这种方法可以识别出更多的运动能力低下的患者,从而有可能预防不良事件.
科学领域:
- 医学研究 医学研究
- 临床信息学是一种临床信息学.
- 患者安全 患者安全
背景情况:
- 住院患者由于运动能力下降而面临静脉血栓栓塞 (VTE) 的风险增加.
- 目前的VTE风险评估通常依赖于主观和非标准化的移动性评估,导致潜在的风险低估和预防措施不足.
研究的目的:
- 评估约翰霍普金斯-最高水平的移动性 (JH-HLM) 评分的有效性,作为评估住院患者减少移动性的客观指标.
- 为了比较JH-HLM得分的预测价值与传统的入院医疗保健专业人员对医院获得的VTE风险的评估.
主要方法:
- 一项回顾性研究分析了四级学术医院的1715名患者.
- 数据包括帕多瓦风险工具评估和客观的JH-HLM得分; 减少的流动性被定义为JH-HLM ≤3连续≥3天.
- 多变量后勤回归评估了减少运动 (JH-HLM) 和医院获得的VTE之间的关联,与入院评估进行了比较.
主要成果:
- 共有33名患者 (1.9%) 患有静脉瘤.
- 根据JH-HLM得分,减少运动与VTE显著相关 (调整后OR:2.53,P = .012),与帕多瓦评估不同.
- JH-HLM确定了19.1%的运动能力低下患者,而接受专业人员的6.5%,表明37名患者被错误分类.
结论:
- 主观的初始流动性评估可能不准确地反映患者在整个住院期间的流动性状态.
- 目标移动性评估工具,如JH-HLM,对于准确的VTE风险评估和改善预防策略的实施至关重要.
相关概念视频
Assessment of the Cardiovascular System III: Palpation
321
Palpation involves feeling the body to evaluate texture, size, consistency, and tenderness for assessing cardiovascular health. The following steps are organized in a head-to-toe order:
Jugular Venous Pressure (JVP) Measurement
Position the patient at a thirty- to forty-five-degree angle or in a semi-fowler's position. Look for the highest point of pulsation in the internal jugular vein and measure the vertical distance to the angle of Loius or sternal angle. A normal JVP is 3-4 cm above...
Jugular Venous Pressure (JVP) Measurement
Position the patient at a thirty- to forty-five-degree angle or in a semi-fowler's position. Look for the highest point of pulsation in the internal jugular vein and measure the vertical distance to the angle of Loius or sternal angle. A normal JVP is 3-4 cm above...
321
Venous Return
4.1K
The circulatory system plays a crucial role in ensuring the optimal functioning of the human body. One of its critical components is venous return - the process that completes the blood circulation cycle. This article will delve into the concept of venous return, how it works, and its significance to our health.
What is Venous Return?
Venous return refers to the rate at which blood flows back to the heart from the body's peripheral veins. It's an integral part of the circulatory system...
What is Venous Return?
Venous return refers to the rate at which blood flows back to the heart from the body's peripheral veins. It's an integral part of the circulatory system...
4.1K
Pre-Procedural Guidelines for Assessing Blood Pressure
563
Accurate blood pressure assessment is crucial for diagnosing and managing various health conditions. To ensure the reliability of these measurements, healthcare professionals must adhere to standardized pre-procedural guidelines. These guidelines enhance patient safety and improve the overall quality of healthcare. The following steps are essential for obtaining accurate and consistent blood pressure readings, from using the appropriate tools to ensuring effective communication with the...
563
Assessment of the Cardiovascular System II: Inspection
230
Inspection is the initial step in assessing the cardiovascular system. It involves a detailed visual examination that provides crucial information about a patient's circulatory and cardiac health. This systematic process, conducted from head to toe, helps identify signs of cardiovascular conditions by observing physical appearance, skin and mucous membranes, jugular and carotid pulsations, chest symmetry, and the condition of the extremities.
Head and Neck
Head and Neck
230


