Wright G, Elliott K, Wilkie C, Cuschieri R J, Bittiner B, Hughes K B
Doncaster Royal Infirmary, South Yorkshire, UK.
Int J Clin Pract. 1999 Oct-Nov;53(7):497-504.
The incidence of symptomatic deep vein thrombosis and pulmonary embolism acquired in hospital was studied, and the effectiveness of current thromboprophylaxis was assessed in an open study of 8648 admissions to the Doncaster Royal Infirmary between April and July 1994. On admission, all patients were assessed for their likely risk of thromboembolic problems according to THRIFT criteria. Treatment, prophylaxis, complications and outcome were recorded on discharge. A high risk sub-group was followed up for up to 42 days after discharge. The overall rate of clinically apparent hospital-acquired thromboembolic complications was 0.4% (n = 35). The rate of clinically apparent thromboembolic disease in the high risk group was 2.1% (n = 17). The incidence of thromboembolic problems appeared not to be reduce by prophylaxis apparently even when stratified by risk group. These findings suggest that thromboembolic complications may be less common than would be expected from published literature. Thromboprophylaxis as currently practised within our institution does not seem to affect the incidence of deep vein thrombosis or pulmonary embolism, and these results would appear to argue against a 'blanket' policy for pharmacological thromboprophylaxis.
对医院获得性症状性深静脉血栓形成和肺栓塞的发生率进行了研究，并在一项开放性研究中评估了当前血栓预防措施的有效性，该研究涉及1994年4月至7月间唐卡斯特皇家医院的8648例住院患者。入院时，根据THRIFT标准对所有患者的血栓栓塞问题风险进行评估。出院时记录治疗、预防、并发症和结果。对高风险亚组患者出院后随访长达42天。临床上明显的医院获得性血栓栓塞并发症总发生率为0.4%（n = 35）。高风险组中临床上明显的血栓栓塞疾病发生率为2.1%（n = 17）。即使按风险组分层，预防措施似乎也未降低血栓栓塞问题的发生率。这些发现表明，血栓栓塞并发症可能比已发表文献预期的更为少见。我们机构目前实施的血栓预防措施似乎并未影响深静脉血栓形成或肺栓塞的发生率，这些结果似乎反对采用“一刀切”的药物性血栓预防策略。
