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在患有急性肺栓塞的老年患者中,风险评估和管理策略
Dieuwke Luijten1, Denise Abbel2, Suzanne C Cannegieter3
1Department of Internal Medicine-Section of Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, Netherlands.
Journal of thrombosis and haemostasis : JTH
|October 25, 2024
概括
使用Hestia标准对肺栓塞 (PE) 的老年人进行家庭治疗是安全的,死亡率为0%. 高风险PE患者面临显著的死亡率,即使在再输血治疗.
科学领域:
- 老年医学 老年医学
- 心脏病学 心脏病学
- 肺部医学 肺部医学
背景情况:
- 在老年人中管理急性肺栓塞 (PE) 存在独特的挑战.
- 老年患者通常在临床试验中代表性不足,并具有更高的并发症风险.
- 老年患者的并发症使PE管理和风险分层复杂化.
研究的目的:
- 评估PE老年患者的风险评估策略.
- 评估老年PE患者在家庭治疗和再注射治疗的结果.
- 确定当前风险分层工具在这个人群中的安全性和有效性.
主要方法:
- 对70岁以上被诊断患有急性PE的患者进行了回顾性分析.
- 在学术医疗中心从2015年到2022年收集的数据.
- 评估Hestia标准,欧洲心脏病学会 (ESC) 风险分类和急性呈现老年患者 (APOP) 评分.
主要成果:
- 家庭治疗 (n=81) 显示0%的14天死亡率和复发性静脉血栓栓塞 (VTE).
- 高风险PE患者 (n=20) 的14天死亡率为51%,在接受再输血治疗的8名患者中,有5人在5天内死亡.
- 确定的APOP得分≥45%的患者14天死亡率明显较高 (28%对3.2%).
结论:
- 赫斯蒂亚标准使老年PE患者能够选择安全的家庭治疗.
- 高风险的PE患者表现得不佳,尽管进行了再输血治疗.
- ESC和APOP分数是识别老年PE患者高死亡风险的有价值工具.
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