静脉血栓栓塞发生率,烧伤患者的危险因素和预防:国家创伤数据库研究
Eloise W Stanton1,2, Artur Manasyan1, Callie M Thompson3
1Department of Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA.
概括
静脉血栓栓塞 (VTE) 影响1.7%的烧伤患者. 危险因素包括年龄,BMI和男性性别. 低分子量肝素和及时的预防改善了结果.
科学领域:
- 烧伤护理 烧伤护理
- 血管外科 血管外科
- 创伤外科 手术 创伤外科
背景情况:
- 静脉血栓塞栓症 (VTE) 是燃烧护理的一个重大问题,但关于其发生率,危险因素和预防的全面数据有限.
- 了解烧伤患者的VTE流行病学对于开发有效的患者管理策略至关重要.
研究的目的:
- 在一大批烧伤患者中描述VTE的发病率和风险因素.
- 为了比较不同的VTE化疗预防策略的有效性.
- 为国家一级的预防策略提供信息,在烧伤护理.
主要方法:
- 从美国国家创伤数据库 (2007-2021) 对烧伤患者的数据分析.
- 描述性统计和多变量回归以确定VTE风险因素.
- 在不同的化疗预防方案中比较VTE发病率.
主要成果:
- 1.7% (5642/326,614) 的烧伤患者经历了静脉瘤.
- 老年患者,男性,体重指数较高的患者,以及燃烧的总体体表面积比例较大的人群中,静脉瘤风险更高.
- 吸烟,高血压,心肌梗塞和物质使用障碍是重要的静脉瘤预测因素.
- 与肝素相比,低分子量肝素与较低的静脉瘤发作率有关 (OR:0.564).
- 延迟VTE化疗预防 (>6小时) 增加了VTE风险 (OR:1.04).
结论:
- 在烧伤患者中确定了VTE的主要人口和临床风险因素.
- 低分子量肝素在静脉瘤预防中表现出比肝素更高的疗效.
- 及时启动VTE化疗对减少烧伤患者的VTE事件至关重要.
- 这些发现可以完善风险分层,并指导基于证据的预防策略,以提高护理质量.
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