术后高凝血和血栓形成:先天性心脏手术后的成本分析
Puja Dutta1, Meena Nathan1,2, Sitaram M Emani1,2
1Department of Cardiac Surgery, Boston Children's Hospital, Boston, MA, USA.
Pediatric cardiology
|June 20, 2024
概括
在先天性心脏病患者接受手术的术后血栓形成与更高的成本和更糟糕的结果有关. 手术前的高凝血状态和红细胞输血预测了血栓形成的风险.
科学领域:
- 心血管外科心血管外科
- 血液学 血液学 血液学
- 儿童心脏病学 儿童心脏病学
背景情况:
- 血栓形成是先天性心脏手术后的严重并发症,与患者不良结果有关.
- 超纤维蛋白质血症和高凝血状态可能会增加这些患者的血栓形成风险.
- 了解血栓形成的预测因素对于改善手术结果和管理成本至关重要.
研究的目的:
- 在先天性心脏手术患者中研究术前前凝血剂产品使用,高纤维素生成血症和术后血栓形成之间的关联.
- 为了确定患上术后血栓形成的危险因素.
- 评估血栓形成对医院费用和患者结果的影响.
主要方法:
- 使用波士顿儿童医院 (2015-2018) 电子健康记录的单中心回顾性研究.
- 包括接受先天性心脏手术的患者,术后纤维素水平> 400 mg/dL.
- 分析了334名患者的数据,评估了术后血栓形成以及相关的临床和成本因素.
主要成果:
- 在334名患有高纤维素因子的患者中,28名 (8.4%) 患有术后血栓形成.
- 术前高凝血状态 (OR:2.58) 术后红细胞输血 (OR:1.007) 和单心室生理学 (OR:2.94) 预测了血栓形成.
- 血栓形成与增加的医院费用,更长的通风和更长的住院/ICU停留有关.
结论:
- 在先天性心脏手术中术后血栓形成与更糟糕的住院结果和更高的成本有关.
- 手术前的高凝血状态和手术后的红细胞输血是血栓形成的重要预测因素.
- 需要开发风险预测模型,以有效预防这种患者群体的血栓形成.
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