基于梅纳德的风险评估模型对静脉血栓塞栓症住院患者预防的实施:前后研究
Belisa Marin Alves1,2, Raquel Pereira Vieira2, Larissa Luma Tomasi Febras2
1Graduate Program in Pulmonary Sciences, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre 91501-970, RS, Brazil.
Healthcare (Basel, Switzerland)
|December 30, 2025
概括
评估静脉血栓塞栓症 (VTE) 风险的电子工具并没有改善住院患者的预防充分性. 梅纳德模型低估了高风险病例,特别是在骨科手术患者中.
科学领域:
- 临床医学 临床医学
- 医疗保健服务研究 医疗服务研究
- 预防医学 预防医学
背景情况:
- 静脉血栓栓塞 (VTE) 是住院患者的重大威胁.
- 不充分利用静脉瘤风险评估和预防有助于预防可能发生的事件.
- 有效地实施静脉瘤预防方案对于患者的安全至关重要.
研究的目的:
- 评估电子风险分层工具与VTE预防的多方面的干预相结合的有效性.
- 评估在巴西莫因霍斯德文托医院的成年临床和手术患者中实施VTE预防方案.
- 将梅纳德风险评估模型与VTE风险分层的帕多瓦和卡普里尼分数进行比较.
主要方法:
- 基于医院的前后前性研究 (2017-2019) 涉及772名患者.
- 使用基于梅纳德模型的电子工具进行VTE风险分层.
- 将电子工具分类与帕多瓦和卡普里尼分数进行比较;根据机构协议评估预防的充分性.
主要成果:
- 梅纳德模型将0.9%的风险归类为低风险,76.4%的风险为中等风险,22.7%的风险为高风险,骨科手术患者的风险有显著差异.
- 总体预防的充分性为69.3%,在研究阶段之间没有显著变化.
- 整形外科手术患者在第二阶段 (p=0.02) 的预防充分性显著下降.
结论:
- 与帕多瓦和卡普里尼分数相比,梅纳德模型低估了高风险VTE分类,特别是在骨科手术患者中.
- 电子工具和多方面的干预措施并没有提高VTE预防的充分性.
- 为了预防VTE,需要进一步完善风险评估工具和实施策略.
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