外科患者血栓栓塞不适当化学预防的相关因素。

Factors associated with inappropriate chemical prophylaxis of thromboembolism in surgical patients.

作者信息

Khorgami Zhamak, Mofid Roza, Soroush Ahmadreza, Aminian Ali, Araghi Negin Hosseini, Hanafi Somayeh

机构信息

Department of Surgery and Research Center for Improvement of Surgical Procedures and Outcomes, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.

Department of Surgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran

出版信息

Clin Appl Thromb Hemost. 2014 Jul;20(5):493-7. doi: 10.1177/1076029612467844. Epub 2012 Dec 4.

DOI:10.1177/1076029612467844

PMID:23223391

Abstract

INTRODUCTION

Despite various guidelines for venous thromboembolism (VTE) prevention, malpractice in prescribing thromboprophylaxis is common. In this study, factors associated with prescribing or not prescribing appropriate chemical thromboprophylaxis were assessed.

MATERIALS AND METHODS

We enrolled high-risk patients for VTE (based on Caprini score) in the general surgery ward. They were divided into 2 groups based on receiving appropriate prophylaxis or not. Factors associated with prescribing thromboprophylaxis were analyzed.

RESULTS

A total of 613 patients were enrolled in this study. Head and neck operations (P < .0001), minor surgeries (P = .001), mastectomy (P = .012), and medical treatment (P = 0.034) were the factors associated with not prescribing thromboprophylaxis. In contrast, age (P < .0001), laparoscopic surgeries (P = .011), surgery duration (< .0001), oral contraceptive pill consumption (P = .005), and complete bed rest (P = .002) were protective factors.

CONCLUSION

Minor surgeries, head and neck operations, mastectomy, and medical treatment are associated with overlooking anticoagulant administration. It is recommended to consider aforementioned pitfalls in routine practice and education.

摘要

引言

尽管有各种静脉血栓栓塞症（VTE）预防指南，但在开具血栓预防药物方面的不当做法很常见。在本研究中，评估了与开具或未开具适当化学血栓预防药物相关的因素。

材料与方法

我们纳入了普通外科病房中VTE高危患者（基于Caprini评分）。根据是否接受适当的预防措施将他们分为两组。分析了与开具血栓预防药物相关的因素。

结果

本研究共纳入613例患者。头颈部手术（P <.0001）、小手术（P =.001）、乳房切除术（P =.012）和内科治疗（P = 0.034）是与未开具血栓预防药物相关的因素。相比之下，年龄（P <.0001）、腹腔镜手术（P =.011）、手术持续时间（<.0001）、口服避孕药使用（P =.005）和完全卧床休息（P =.002）是保护因素。