手术和创伤之间的关系,以及与第一静脉血栓事件相关的患者的复发风险:一个嵌套的病例对照研究
T Gregorio1,2, K J Creeper3,4, L Pagliani5
1Internal Medicine Department, Unidade Local de Saúde de Gaia e Espinho-V. N. Gaia, Portugal.
Thrombosis and haemostasis
|March 5, 2025
概括
静脉血栓栓塞 (VTE) 的复发风险在轻微手术后比大手术后更高. 这一发现表明,微微引起的VTE比主要的短暂因素引起的VTE具有更大的风险.
科学领域:
- 心脏病学 心脏病学
- 血管医学 血管医学
- 血栓形成研究研究
背景情况:
- 静脉血栓塞栓症 (VTE) 的抗凝固治疗持续时间取决于事件是否被诱导或未被诱导.
- 大型手术或创伤已知是具有低复发风险的VTE诱发因素,但轻微手术/创伤后的风险尚不清楚.
研究的目的:
- 为了比较小手术/创伤引起的患者和大手术/创伤引起的患者的VTE复发率.
- 调查VTE复发风险与最小诱发事件相关的程度.
主要方法:
- 嵌套病例控制研究,包括在手术或创伤后90天内首次发生静脉动脉突发症的患者.
- 排除了未引起的VTE或由癌症/非手术因素引起的VTE的患者.
- 计算的原始和调整的赔率比率与95%的置信区间,调整为混因素.
主要成果:
- 经过小手术引起的VTE后的复发发病率 (6.5%) 是大手术后的两倍以上 (3.0%).
- 在调整已知的VTE风险因素后,这种差异仍然存在.
- 在轻微与重大创伤引起的VTE之间没有观察到复发率的显著差异.
结论:
- 与大手术相比,小手术引起VTE的患者的VTE复发风险较高.
- 研究结果支持这样一个假设:引起VTE的最小程度,与引起主要短暂因素的VTE相比,具有更高的复发风险.
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