英国脚血栓塞栓症 (英国-FATE)
Jitendra Mangwani1,2,3, Linzy Houchen-Wolloff4, Karan Malhotra5
1Academic Team of Musculoskeletal Surgery, Department of Trauma and Orthopaedics, University Hospitals of Leicester NHS Trust, Leicester, UK.
静脉血栓塞栓症 (VTE) 在脚/脚手术和阿基里斯肌 (TA) 破裂后很罕见,死亡率低. 风险因素包括TA断裂和美国麻醉学会 (ASA) 的高等级,与各种预防使用.
科学领域:
- 整形外科手术 整形外科手术
- 血管外科 血管外科
- 临床审计 临床审计
背景情况:
- 静脉血栓栓塞 (VTE) 是足手术后的一个已知的并发症.
- 目前的指导方针缺乏关于该患者群体VTE风险因素和化学预防的共识.
- 阿基里斯肌 (TA) 破裂是一种特定的疾病,通常通过手术或非手术治疗.
研究的目的:
- 为了确定足手术和TA断裂后90天症状性VTE和VTE相关死亡率的发生率.
- 为了评估化学预防管理的变化.
- 确定预测VTE发展的关键风险因素.
主要方法:
- 一个多中心,前性的国家协作审计在英国医院进行了九个月的时间.
- 收集了接受足手术或TA断裂治疗的患者的数据.
- 用单变量和多变量逻辑回归模型来评估静脉瘤风险因素和与血栓预防的关联.
主要成果:
- 分析了11,363名患者;记录了99例VTE (0.87%的发病率) 和0.03%的VTE相关死亡率.
- 低分子量肝素是最常见的抗凝剂,但32.71%的患者没有接受化学预防.
- 增加年龄,更高的美国麻醉学会 (ASA) 评级,以及先前的VTE病史与更高的VTE概率有关. 脚手术类型和ASA等级是最强的预测因素.
结论:
- 在接受足手术和TA断裂管理的患者中,症状性VTE和相关死亡率的90天发病率较低.
- 在所规定的化学预防中存在显著的变化.
- 阿基里斯肌破裂和高ASA等级是90天症状性静脉瘤的重要危险因素.
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