发生静脉血栓栓塞的神经外科患者的预后：RIETE注册研究综述
Outcomes in neurosurgical patients who develop venous thromboembolism: a review of the RIETE registry.
作者信息
Cote Lauren P, Greenberg Steven, Caprini Joseph A, Stone James, Arcelus Juan I, López-Jiménez Luciano, Rosa Vladimir, Schellong Sebastian, Monreal Manuel
机构信息
Department of Nursing/Critical Care, Evanston Hospital, NorthShore University HealthSystem, Chicago, IL, USA
Department of Anesthesia/Critical Care, Evanston Hospital, NorthShore University HealthSystem, Chicago, IL, USA.
出版信息
Clin Appl Thromb Hemost. 2014 Nov;20(8):772-8. doi: 10.1177/1076029614532008. Epub 2014 May 5.
OBJECTIVES
Registro Informatizado de Enfermedad TromboEmbólica (RIETE) database was used to investigate whether neurosurgical patients with venous thromboembolism (VTE) were more likely to die of bleeding or VTE and the influence of anticoagulation on these outcomes.
METHODS
Clinical characteristics, treatment details, and 3-month outcomes were assessed in those who developed VTE after neurosurgery.
RESULTS
Of 40 663 patients enrolled, 392 (0.96%) had VTE in less than 60 days after neurosurgery. Most patients in the cohort (89%) received initial therapy with low-molecular-weight heparin, (33% received subtherapeutic doses). In the first week, 10 (2.6%) patients died (8 with pulmonary embolism [PE], no bleeding deaths; P = .005). After the first week, 20 (5.1%) patients died (2 with fatal bleeding, none from PE). Overall, this cohort was more likely to develop a fatal PE than a fatal bleed (8 vs 2 deaths, P = .058).
CONCLUSIONS
Neurosurgical patients developing VTE were more likely to die from PE than from bleeding in the first week, despite anticoagulation.
目的
使用静脉血栓栓塞性疾病信息登记系统（RIETE）数据库，调查神经外科静脉血栓栓塞（VTE）患者死于出血或VTE的可能性，以及抗凝治疗对这些结局的影响。
方法
对神经外科手术后发生VTE的患者的临床特征、治疗细节和3个月的结局进行评估。
结果
在纳入的40663例患者中，392例（0.96%）在神经外科手术后不到60天发生VTE。队列中的大多数患者（89%）接受低分子量肝素初始治疗，（33%接受低于治疗剂量）。在第一周，10例（2.6%）患者死亡（8例死于肺栓塞[PE]，无出血死亡；P = 0.005）。第一周后，20例（5.1%）患者死亡（2例死于致命性出血，无PE死亡）。总体而言，该队列发生致命性PE的可能性高于致命性出血（8例死亡对2例死亡，P = 0.058）。
结论
神经外科手术后发生VTE的患者，尽管进行了抗凝治疗，但在第一周死于PE的可能性高于出血。
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