在膝下截肢后的静脉血栓栓塞和美国退伍军人的死亡率
Khanh P Nguyen1,2,3, Joshua B Gruber1, Megan L Mertzel1,2
1Research & Development, Portland Veterans Administration Health Care System, Portland, Oregon, USA.
Research and practice in thrombosis and haemostasis
|June 9, 2025
概括
接受膝下截肢 (BKA) 的患者面临静脉血栓塞栓症 (VTE) 的风险. 在BKA后的VTE显著增加了三倍的死亡风险,突出了预防策略的必要性.
科学领域:
- 血管外科手术的结果
- 血栓栓塞性疾病流行病学
- 患者生存分析分析.
背景情况:
- 膝下截肢 (BKA) 构成术后静脉血栓栓塞 (VTE) 的风险.
- 关于VTE发病率及其对BKA后存活率的影响的数据有限.
研究的目的:
- 为了确定BKA之后的VTE发病率.
- 评估BKA后VTE与美国退伍军人全因死亡率之间的关联.
主要方法:
- 对接受BKA的6305名退伍军人的回顾性队列研究 (2016年10月至2023年1月).
- 在90天内使用ICD代码和临床事件 (抗凝药处方,IVC过器或早期死亡) 确定VTE.
- 时间依赖的考克斯比例危险模型评估了VTE与死亡率的关联.
主要成果:
- 在6305名患者中,132名患者 (2.1%) 在BKA后90天内发生了静脉瘤.
- 年龄较小与VTE风险较低相关.
- 在BKA后的VTE与3.17倍的死亡风险增加有关 (aHR:3.17,95%CI:2.12-4.17).
结论:
- 在BKA后的VTE与明显更高的死亡率有关.
- 需要进一步的研究来证实这些发现,并为BKA患者制定VTE预防策略.
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