Department of Geriatric Cardiology, Chinese People's Liberation Army General Hospital, Beijing 100853, China.
Chin Med J (Engl). 2011 Feb;124(3):335-40.
As the third most frequent cardiovascular disease, venous thromboembolism (VTE) remains a major cause of morbidity and mortality in hospitalized patients. The aim of this study was to determine the incidence of VTE and steps for its prevention in acutely ill hospitalized elderly Chinese patients.
A prospective multi-center study was conducted from June 2006 to November 2007. A total of 607 patients from 40 research centers in China were enrolled. Data of the patients' baseline characteristics, VTE events and prophylaxis/therapy methods were collected.
Fifty-nine patients (9.7%) had an objectively confirmed VTE during the 90-day follow-up, of which, 59.3% occurred during the first week and 75% within 14 days. Forty-one patients died (6.6%) during the follow-up, 36.6% died within three weeks. We also found that medical disorders including respiratory failure (16.4%), acute brain infarction (15.6%), acute infectious diseases (14.3%), acute coronary artery syndrome (8.7%) and heart failure (7.6%) play a role in provoking VTE. Only 13.0% of the elderly patients with high risk of VTE used low dose unfractionated heparin, 7.1% used low molecular weight heparin, 5.4% used warfarin, 0.3% used graduated compression stockings and none of them used intermittent pneumatic compression.
Our study showed similar results between our study and western countries in the VTE incidence by day 90 in elderly hospitalized patients with acute medical illness. Great caution must be applied in the care of acutely ill elderly hospitalized patients to deal with the complications of VTE. Application of safe and effective prophylaxes against embolism remains a critical challenge.
静脉血栓栓塞症（VTE）作为第三大常见心血管疾病，仍然是住院患者发病率和死亡率的主要原因。本研究旨在确定急性病住院老年中国患者中 VTE 的发生率及其预防措施。
本研究是一项从 2006 年 6 月至 2007 年 11 月进行的前瞻性多中心研究。共纳入中国 40 个研究中心的 607 例患者。收集患者的基线特征、VTE 事件和预防/治疗方法的数据。
在 90 天的随访期间，59 例患者（9.7%）客观确诊患有 VTE，其中 59.3%发生在第 1 周，75%发生在第 14 天内。41 例患者（6.6%）在随访期间死亡，其中 36.6%在 3 周内死亡。我们还发现，包括呼吸衰竭（16.4%）、急性脑梗死（15.6%）、急性传染病（14.3%）、急性冠状动脉综合征（8.7%）和心力衰竭（7.6%）在内的医疗疾病在诱发 VTE 中发挥作用。仅有 13.0%的 VTE 高危老年患者使用低剂量未分馏肝素，7.1%使用低分子肝素，5.4%使用华法林，0.3%使用梯度压力弹力袜，无一例使用间歇性气动压迫。
我们的研究显示，在急性内科疾病住院老年患者中，90 天内 VTE 的发生率与西方国家相似。在护理急性病住院老年患者时，必须高度警惕 VTE 并发症。应用安全有效的预防栓塞措施仍然是一个关键挑战。
