Yamada Norikazu, Hanzawa Kazuhiko, Ota Satoshi, Nakamura Mashio, Sato Koichi, Ikura Maiko, Suzuki Takeo, Kaise Toshihiko, Nakajima Hiromu, Ito Masaaki
Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, Tsu, Mie, Japan.
Division of Thoracic and Cardiovascular Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Niigata, Japan.
Ann Vasc Dis. 2015;8(3):203-9. doi: 10.3400/avd.oa.14-00132. Epub 2015 Jun 19.
To estimate the frequency of deep vein thrombosis (DVT) among non-surgical inpatients, and to evaluate the D-dimer assay as a screening tool for DVT.
Subjects were non-surgical inpatients aged 20 years or older who had been bedridden for at least 24 hours and had moderate-to-high risk factors for DVT. We assessed the presence of DVT by venous ultrasonography. Patients who received a diagnosis of venous thromboembolism (VTE) before admission, who had symptoms or findings of VTE at admission, or who had surgery or trauma within the past 3 months before admission were excluded.
DVT was confirmed in 96 of 525 patients (18.3%). In a logistic regression analysis, longer duration of hospitalization, higher D-dimer value, and history of cancer surgery were significantly associated with the occurrence of DVT. The D-dimer assay showed high sensitivity (96.1%) and high negative predictive value (97.6%).
Non-surgical inpatients with a long-term hospitalization or history of cancer surgery have a risk for DVT, and need to be considered for added DVT preventive measures as recommended in the prevention guidelines. In addition, the D-dimer assay is beneficial for the screening of DVT in medical practice.
评估非手术住院患者中深静脉血栓形成(DVT)的发生率,并评价D - 二聚体检测作为DVT筛查工具的价值。
研究对象为年龄20岁及以上、卧床至少24小时且具有中至高度DVT危险因素的非手术住院患者。通过静脉超声检查评估DVT的存在情况。排除入院前已诊断为静脉血栓栓塞症(VTE)、入院时有VTE症状或体征、或入院前3个月内接受过手术或创伤的患者。
525例患者中有96例(18.3%)确诊为DVT。在逻辑回归分析中,住院时间延长、D - 二聚体值升高以及癌症手术史与DVT的发生显著相关。D - 二聚体检测显示出高敏感性(96.1%)和高阴性预测值(97.6%)。
长期住院或有癌症手术史的非手术住院患者存在DVT风险,需要按照预防指南的建议考虑采取额外的DVT预防措施。此外,D - 二聚体检测在医疗实践中对DVT筛查有益。