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COPD 住院患者的静脉血栓栓塞症。

Venous thromboembolism in COPD hospitalized patients.

机构信息

Servicio de Medicina Interna, Hospital Infanta Cristina, Avenida 9 Junio no 2, 28981 Parla, Madrid, Spain.

出版信息

J Thromb Thrombolysis. 2012 Jan;33(1):82-7. doi: 10.1007/s11239-011-0646-x.

DOI:10.1007/s11239-011-0646-x
PMID:22016148
Abstract

Patients with chronic obstructive pulmonary disease (COPD) are at increased risk for venous thromboembolism (VTE). We analyzed a large Spanish database to determine the incidence of VTE in these patients during hospitalization. A retrospective chart review of cohort of consecutive patients admitted with COPD as the primary reason for discharge in Spain between January 1st 2006 and December 31st 2007 was performed. For each patient, demographic data, risk factors for VTE and the diagnosis of VTE during hospitalization was recorded. We analyzed the clinical data of 313,233 adults with acute exacerbations of COPD admitted to the hospital at any public centre in Spain, in 2006 and 2007. We identify 3,562 new diagnosed VTE events among 270,840 COPD patients hospitalized more than two days (incidence 1.32%). Hospitalized-acquired VTE risk factors were male gender (odds ratio [OR] 1.77; CI95% 1.66-1.90), neoplasic disease (OR 2.93 CI95% 2.69-3.16, systemic arterial disease (OR 1.17 CI95% 1.10-1.36), decubitus ulcer (OR 1.19 CI95% 1.01-1.43), diabetes (OR 0.74 IC95% 0.69-0.81), and atrial fibrillation (OR 0.79 CI95% 0.72-0.87). VTE appears as a major threat to patients admitted for acute exacerbation of COPD, and pharmacologic prophylaxis should be considered in all high risk situations.

摘要

患有慢性阻塞性肺疾病(COPD)的患者发生静脉血栓栓塞症(VTE)的风险增加。我们分析了一个大型西班牙数据库,以确定这些患者在住院期间发生 VTE 的发生率。对 2006 年 1 月 1 日至 2007 年 12 月 31 日期间因 COPD 作为主要出院原因连续入院的患者队列进行了回顾性图表审查。对于每例患者,记录了人口统计学数据、VTE 风险因素以及住院期间 VTE 的诊断。我们分析了 2006 年和 2007 年在西班牙任何公共中心因急性 COPD 加重住院的 313233 名成年人的临床数据。我们在 270840 例住院超过两天的 COPD 患者中发现 3562 例新发诊断的 VTE 事件(发生率为 1.32%)。住院获得性 VTE 的危险因素包括男性(比值比 [OR] 1.77;95%CI95% 1.66-1.90)、肿瘤疾病(OR 2.93 CI95% 2.69-3.16)、全身性动脉疾病(OR 1.17 CI95% 1.10-1.36)、褥疮(OR 1.19 CI95% 1.01-1.43)、糖尿病(OR 0.74 IC95% 0.69-0.81)和心房颤动(OR 0.79 CI95% 0.72-0.87)。VTE 似乎是急性 COPD 加重住院患者的主要威胁,所有高危情况均应考虑药物预防。

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本文引用的文献

1
Venous thromboembolism in acutely ill hospitalized medical patients.急性病住院治疗的内科患者中的静脉血栓栓塞症。
Thromb Res. 2010 Oct;126(4):276-9. doi: 10.1016/j.thromres.2010.06.027. Epub 2010 Jul 24.
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Risk factors for venous thromboembolism.静脉血栓栓塞的危险因素。
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Variation in physician deep vein thrombosis prophylaxis attitudes and practices at an academic tertiary care center.在一家学术性三级保健中心,医生对深静脉血栓预防的态度和做法存在差异。
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Venous thromboembolism in Spain. Comparison between an administrative database and the RIETE registry.西班牙的静脉血栓栓塞症。行政数据库与RIETE注册登记处的比较。
Eur J Intern Med. 2008 Oct;19(6):443-6. doi: 10.1016/j.ejim.2007.06.026. Epub 2008 Mar 4.
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Thromboprophylaxis rates in US medical centers: success or failure?美国医疗中心的血栓预防率:成功还是失败?
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