Lee Jinwoo, Kim Seok Chan, Kim Sun Jong, Oh Jin Young, Lee Hyun Kyung, Yum Ho Kee, Kim Yang-Ki, Hong Sang-Bum, Park Moo Suk, Hwang Sung-Chul, Yoon Hyoung Kyu, Kim Hak-Ryul, Cho Jae Hwa, Park Sunghoon, Yoo Chul-Gyu
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
Department of Pulmonology, The Catholic University of Korea School of Medicine, Seoul, Korea.
J Korean Med Sci. 2014 Nov;29(11):1572-6. doi: 10.3346/jkms.2014.29.11.1572. Epub 2014 Nov 4.
Patients admitted to medical intensive care unit (MICU) are at increased risk for venous thromboembolism (VTE); and prophylaxis is recommended. However, the actual range and frequency of VTE prophylaxis administered to MICU patients are not well defined. Patients over 40 yr of age and expected MICU stay of more than 48 hr were eligible for this observational cohort study of 23 MICUs in Korea. Patients already on anticoagulation therapy or those requiring anticoagulation for reasons other than VTE were excluded. Among 830 patients, VTE prophylaxis was given to 560 (67.5%) patients. Among 560 patients, 323 (38.9%) received pharmacoprophylaxis, 318 (38.4%) received mechanical prophylaxis and 81 (9.8%) received both forms of prophylaxis. About 74% of patients in the pharmacoprophylaxis group received low molecular weight heparin and 53% of the patients in the mechanical prophylaxis group used intermittent pneumatic compression. Most of the patients (90%) had more than one risk factor for VTE and the most common risk factor was old age, followed by heart and respiratory failure. In this observational cohort study of 23 MICUs in Korea, 67.5% of patients received thromboprophylaxis. Further studies are needed to clarify the role and efficacy of VTE prophylaxis in Korean critically ill patients.
入住医学重症监护病房（MICU）的患者发生静脉血栓栓塞症（VTE）的风险增加，因此建议进行预防。然而，给予MICU患者VTE预防的实际范围和频率尚不清楚。年龄超过40岁且预计在MICU停留超过48小时的患者符合这项对韩国23个MICU进行的观察性队列研究的条件。已经接受抗凝治疗或因VTE以外原因需要抗凝的患者被排除在外。在830例患者中，560例（67.5%）接受了VTE预防。在560例患者中，323例（38.9%）接受了药物预防，318例（38.4%）接受了机械预防，81例（9.8%）接受了两种预防措施。药物预防组中约74%的患者接受了低分子量肝素，机械预防组中53%的患者使用了间歇性气动压迫。大多数患者（90%）有不止一个VTE危险因素，最常见的危险因素是老年，其次是心脏和呼吸衰竭。在这项对韩国23个MICU的观察性队列研究中，67.5%的患者接受了血栓预防。需要进一步研究以阐明VTE预防在韩国重症患者中的作用和疗效。
