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实践模式和初始抗凝药的结果在住院患者中低风险和低中等风险的肺栓塞
Grace M Ferri1, Om A Kothari1, Sarika D Gurnani1
1Department of Medicine, Boston University Chobanian and Avedisian School of Medicine and Boston Medical Center, Boston, MA.
CHEST pulmonary
|August 8, 2025
概括
患有低风险肺栓塞 (PE) 的住院患者很少接受初始直接口服抗凝剂 (DOAC). 然而,启动DOAC与较短的住院时间有关,与其他PE患者的抗凝血方法相比.
科学领域:
- 心脏病学 心脏病学
- 肺部医学 肺部医学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 指南建议直接口服抗凝剂 (DOAC) 用于低风险的肺栓塞 (PE) 门诊患者.
- 有证据表明,住院的低风险PE患者通常不会在DOAC上出院.
- 这项研究调查了住院的低风险和中低风险PE患者的抗凝模式.
研究的目的:
- 检查不同机构中住院患有低风险和中低风险PE患者的抗凝血实践的差异.
- 为了比较与不同初始抗凝策略相关的结果.
主要方法:
- 使用PINC人工智能增强行政数据库 (2016-2022) 进行的多中心回顾性队列研究.
- 包括在入院时患有PE的住院成年患者,在第一天或之后开始服用抗凝药 (UFH,LMWH/fondaparinux或DOAC).
- 排除了患有高托罗或大脑尿素水平的患者.
主要成果:
- 在2369名符合条件的患者中,54%接受了未分离氨酸 (UFH),41%接受了低分子量氨酸 (LMWH) / fondaparinux,只有4%最初接受了DOAC.
- 初始的DOAC治疗与初始的UFH相比,与停留时间中位数减少0.62天有关.
结论:
- 患有低风险和中低风险PE的住院患者很少接受DOAC治疗.
- 尽管初始吸收率低,但DOAC疗法与其他PE初始抗凝策略相比,显示了更短的住院时间.
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