Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
Department of Internal Medicine, School of Medicine, CHA University, Seongnam, Korea.
J Korean Med Sci. 2014 Feb;29(2):164-71. doi: 10.3346/jkms.2014.29.2.164. Epub 2014 Jan 28.
In 2010, we proposed the first Korean Guidelines for the Prevention of Venous Thromboembolism (VTE). It was applicable to Korean patients, by modifying the contents of the second edition of the Japanese guidelines for the prevention of VTE and the 8th edition of the American College of Chest Physicians (ACCP) evidence-based clinical practice guidelines. From 2007 to 2011, we conducted a nationwide study regarding the incidence of VTE after major surgery using the Health Insurance Review and Assessment Service (HIRA) database. In addition, we have considered the 9th edition of the ACCP Evidenced-Based Clinical Practice Guidelines, published in 2012. It emphasized the importance of clinically relevant events as opposed to asymptomatic outcomes with preferences for both thrombotic and bleeding outcomes. Thus, in the development of the new Korean guidelines, three major points were addressed: 1) the new guidelines stratify patients into 4 risk groups (very low, low, moderate, and high) according to the actual incidence of symptomatic VTE from the HIRA databases; 2) the recommended optimal VTE prophylaxis for each group was modified according to condition-specific thrombotic and bleeding risks; 3) guidelines are intended for general information only, are not medical advice, and do not replace professional medical care and/or physician advice.
2010 年,我们提出了第一版韩国预防静脉血栓栓塞症(VTE)指南。该指南适用于韩国患者,通过修改日本 VTE 预防指南第二版和美国胸科医师学会(ACCP)第 8 版基于证据的临床实践指南的内容。从 2007 年到 2011 年,我们使用健康保险审查和评估服务(HIRA)数据库对主要手术后 VTE 的发生率进行了全国性研究。此外,我们还考虑了 2012 年发布的 ACCP 第 9 版基于证据的临床实践指南。该指南强调了临床相关事件的重要性,而不是无症状结果,并对血栓形成和出血结果均有所偏好。因此,在制定新的韩国指南时,我们主要关注三个方面:1)根据 HIRA 数据库中来自实际症状性 VTE 的发生率,新指南将患者分为 4 个风险组(极低、低、中、高);2)根据特定疾病的血栓形成和出血风险,修改了每个组推荐的最佳 VTE 预防措施;3)指南仅供一般信息参考,不是医疗建议,也不能替代专业的医疗护理和/或医生建议。