创伤患者在医院出院后发生静脉血栓塞栓事件
Jacob M Dougherty1, Laura J Gerhardinger, Patrick L Johnson
1From the Wayne State University School of Medicine (J.M.D.), Detroit; Department of Surgery (L.J.G., P.L.J., S.E.R., N.F.S., R.A.J., M.R.H.) and Center for Healthcare Outcomes and Policy (L.J.G., P.L.J., S.E.R., N.F.S., R.A.J., M.R.H., B.W.O.), University of Michigan, Ann Arbor, Michigan; Department of Surgery (J.W.S.), University of Washington, Seattle, Washington; and Department of Orthopaedic Surgery (B.W.O.), University of Michigan, Ann Arbor, Michigan.
重伤患者在出院后面临静脉血栓栓塞 (VTE) 的高风险. 这项研究确定了出院后VTE的关键风险因素,强调了需要持续监测和改进的预防策略的需要.
科学领域:
- 创伤外科手术是什么
- 这是血管外科手术.
- 流行病学 流行病学
背景情况:
- 静脉血栓塞栓症 (VTE) 是严重创伤后的一种严重并发症.
- 排放后对VTE的监测是有限的,阻碍了对长期风险的理解.
- 这项研究调查了创伤患者在医院出院后的第一年VTE的发病率和危险因素.
研究的目的:
- 在创伤患者中表征出院后VTE的发生率和时间.
- 为了确定患者,损伤和治疗相关的风险因素,以获得退院后的VTE.
- 为改善创伤幸存者的VTE结果的策略提供信息.
主要方法:
- 利用了来自35个创伤中心的34421名成年创伤患者的数据 (2018-2023年).
- 将创伤登记数据与保险索赔联系起来,以识别出院后的VTE事件.
- 采用多变量逻辑回归来确定放电后VTE的预测因素.
主要成果:
- 4.3%的患者在出院后的一年内发生了静脉瘤,而在住院期间为0.8%.
- 退院后,VTE发病率仍然很高,其中40%发生在30天内,73%发生在3个月内.
- 显著的危险因素包括手术,脊柱损伤,黑人种族和输血.
结论:
- 在创伤患者中,大多数VTE事件发生在医院出院后.
- 退院后的VTE是一种未被认可但可治疗的疾病.
- 纵向的患者记录和更好地了解风险因素对于治疗退院后的VTE至关重要.
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