Arpaia Guido, Ambrogi Federico, Penza Maristella, Ianes Aladar Bruno, Serras Alessandra, Boracchi Patrizia, Cimminiello Claudio
Departimento di Medicina, Azienda Ospedaliera di Desio e Vimercate, Via SS Cosma e Damiano 10, 20059 Vimercate, Italy.
Int J Vasc Med. 2011;2011:305027. doi: 10.1155/2011/305027. Epub 2011 Jun 13.
Background. This study investigated the prevalence of and impact of risk factors for deep venous thrombosis (DVT) in patients with chronic diseases, bedridden or with greatly limited mobility, cared for at home or in long-term residential facilities. Methods. We enrolled 221 chronically ill patients, all over 18 years old, markedly or totally immobile, at home or in long-term care facilities. They were screened at the bedside by simplified compression ultrasound. Results. The prevalence of asymptomatic proximal DVT was 18% (95% CI 13-24%); there were no cases of symptomatic DVT or pulmonary embolism. The best model with at most four risk factors included: previous VTE, time of onset of reduced mobility, long-term residential care as opposed to home care and causes of reduced mobility. The risk of DVT for patients with reduced mobility due to cognitive impairment was about half that of patients with cognitive impairment/dementia. Conclusions. This is a first estimate of the prevalence of DVT among bedridden or low-mobility patients. Some of the risk factors that came to light, such as home care as opposed to long-term residential care and cognitive deficit as causes of reduced mobility, are not among those usually observed in acutely ill patients.
背景。本研究调查了在家中或长期居住设施中接受护理的慢性病、卧床不起或行动严重受限患者深静脉血栓形成（DVT）的患病率及其危险因素的影响。方法。我们纳入了221例慢性病患者，均为18岁以上，明显或完全行动不便，在家中或长期护理机构中。通过简化的压迫超声在床边对他们进行筛查。结果。无症状近端DVT的患病率为18%（95%可信区间13 - 24%）；没有症状性DVT或肺栓塞病例。包含最多四个危险因素的最佳模型包括：既往静脉血栓栓塞症（VTE）、行动能力下降的起始时间、与家庭护理相对的长期居住护理以及行动能力下降的原因。因认知障碍导致行动不便的患者发生DVT的风险约为因认知障碍/痴呆导致行动不便患者的一半。结论。这是对卧床或行动能力低下患者中DVT患病率的首次估计。一些已发现的危险因素，如与长期居住护理相对的家庭护理以及作为行动能力下降原因的认知缺陷，并非急性病患者中通常观察到的危险因素。
