Division of Hematology and Medical Oncology, Department of Internal Medicine, King Hussein Cancer Center, Queen Rania Al Abdullah Street, PO Box 1269, Amman 11941, Jordan,
J Thromb Thrombolysis. 2010 Oct;30(3):286-93. doi: 10.1007/s11239-010-0445-9.
Cancer and its treatment are recognized risk factors for VTE. Compliance rate with published VTE prophylaxis guidelines is low. Decision on when to offer prophylaxis for hospitalized cancer patients is difficult to make. This paper describes current clinical practice in offering VTE prophylaxis to hospitalized cancer patients. Prophylaxis rate and rate of VTE will be correlated with the risk level. We prospectively followed all consecutive adult cancer patients admitted to medical units over a 5-month period. Caprini risk assessment model, with some modifications, was utilized to determine risk of VTE. Six hundred and six patients (51% males, median age 52 years, range 18-91) were included. Reasons for admission included infections (25%), chemotherapy (22%) and palliative care (10%). In addition to cancer, the most frequently encountered risk factors for VTE were: Immobilization (35%), age > 60 years (31%) and body mass index > 30 in (20%). Patients were grouped according to their total risk score: low (9%), moderate (44%) and high risk (47%). VTE prophylaxis rate was 55.1% for the whole study group. Following discharge, patients were followed for 60 days. The incidence of VTE was 3.4% in the moderate and 4.2% in the high risk groups, while none in the low risk group developed VTE. Many additional risk factors for VTE are usually encountered in hospitalized cancer patients. Cancer alone may not be an enough reason for VTE prophylaxis. Risk assessment model able to stratify patients into different risk categories will simplify decision making and enhance VTE prophylaxis rate.
癌症及其治疗被认为是 VTE 的风险因素。发表的 VTE 预防指南的依从率很低。对于住院癌症患者何时提供预防措施的决策非常困难。本文描述了为住院癌症患者提供 VTE 预防的当前临床实践。预防率和 VTE 发生率将与风险水平相关。我们前瞻性地随访了在 5 个月期间入住内科病房的所有连续成年癌症患者。利用经一些修改的 Caprini 风险评估模型来确定 VTE 的风险。共纳入 606 例患者（51%为男性，中位年龄为 52 岁，范围为 18-91 岁）。入院的原因包括感染（25%）、化疗（22%）和姑息治疗（10%）。除癌症外，VTE 的最常见危险因素还包括：固定不动（35%）、年龄 > 60 岁（31%）和 BMI > 30（20%）。根据患者的总风险评分将患者分为低危（9%）、中危（44%）和高危（47%）三组。整个研究组的 VTE 预防率为 55.1%。出院后，对患者进行了 60 天的随访。中危组和高危组的 VTE 发生率分别为 3.4%和 4.2%，而低危组无一例发生 VTE。住院癌症患者通常还存在许多其他 VTE 危险因素。单纯癌症可能不是 VTE 预防的充分理由。能够对患者进行分层的风险评估模型将简化决策并提高 VTE 预防率。
