前腹膜包装是否会增加创伤患者的静脉血栓栓塞的风险? 在17个I级创伤中心进行了前性的多中心分析
Lisa Marie Knowlton1, Angela Sauaia, Ernest E Moore
1From the Section of Trauma, Surgical Critical Care and Acute Care Surgery, Department of Surgery (L.M.K.), Stanford University School of Medicine; Stanford-Surgery Policy Improvement Research and Education Center (S-SPIRE) (L.M.K.), Stanford, California; Department of Surgery (A.S., E.E.M.), University of Colorado Denver, Aurora; Ernest E Moore Shock Trauma Center (A.S., E.E.M.), Denver Health, Denver, Colorado; and Department of Surgery (M.M.K.), University of California San Francisco, San Francisco, California.
像ORIF,PA和PPP这样的骨盆骨折干预措施不是独立的VTE风险因素. 在24小时内早期的VTE预防可显著降低高风险患者的VTE风险.
科学领域:
- 创伤外科手术是什么
- 这是血管外科手术.
- 血栓塞栓症的研究研究.
背景情况:
- 骨盆骨折携带高风险的静脉血栓塞栓症 (VTE).
- 在骨盆骨折治疗中,预腹骨盆包装 (PPP) 被怀疑是VTE风险因素.
- 调查与骨盆血管栓塞 (PA),PPP和骨盆开放缩减内部固定 (ORIF) 相关的VTE风险至关重要.
研究的目的:
- 在接受PPP,PA或ORIF的骨盆骨折患者中评估VTE的风险.
- 为了比较不同骨盆骨折干预和没有干预的VTE发病率.
主要方法:
- 使用来自创伤性血栓栓塞研究领导者联盟 (CLOTT) 数据的观察性研究.
- 包括1387名骨盆骨折患者 (年龄在18-40岁,有静脉瘤风险因素).
- 通过使用竞争性风险分析,比较PPP,PA,ORIF和没有盆腔干预的VTE结果.
主要成果:
- 整体VTE发生率为5.6%.
- 在ORIF中,VTE发病率最高 (24.7%),其次是PPP (9.0%) 和PA (2.6%).
- 多变量分析发现PPP,PA或ORIF和VTE之间没有显著的关联. 早期VTE预防 (24小时内) 将VTE发病率减半.
结论:
- 骨盆骨折干预 (PPP,PA,ORIF) 不是独立的静脉瘤风险因素.
- 在入院24小时内启动静脉瘤预防药物治疗对于在高风险的骨盆骨折患者中减少静脉瘤至关重要.
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