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2010 - 2013年维多利亚州急性创伤性脊髓损伤患者静脉血栓栓塞相关因素的探索性分析

Exploratory analysis of factors associated with venous thromboembolism in Victorian acute traumatic spinal cord-injured patients 2010-2013.

作者信息

Clements R, Churilov L, Wahab A L A, Ng L C

机构信息

Victorian Spinal Cord Service Austin Health, Heidelberg, Victoria, Australia.

Statistics and Decision Analysis Academic Platform, The Florey Institute of Neuroscience and Mental Health, RMIT University, Melbourne, Victoria, Australia.

出版信息

Spinal Cord. 2017 Jan;55(1):74-78. doi: 10.1038/sc.2016.94. Epub 2016 Jun 14.

Abstract

STUDY DESIGN

A retrospective medical records audit.

OBJECTIVES

To investigate the presence of venous thromboembolism (VTE) events following acute traumatic spinal cord injury (SCI) and the association between VTE events and a number of postulated risk factors.

SETTING

The state-wide SCI service in Victoria Australia (Victorian Spinal Cord Service) located at Austin Hospital Melbourne Australia.

METHODS

A retrospective electronic medical records file audit was performed of all patients admitted to VSCS between 2010 and 2013 with an acute traumatic SCI. The outcome measure was the presence of VTE (deep venous thrombosis (DVT), pulmonary embolism (PE) or both). Data were also collected on a variety of established and postulated risk factors for VTE post SCI.

RESULTS

VTE events occurred in 21.2% of acute SCI patients during the hospitalisation of the patient. Statistically significant associations were found between the presence of VTE events and increased weight, male sex, completeness of motor paralysis, length of stay (LOS), associated pelvic or lower limb fracture and delayed admission to the state-wide spinal cord service.

CONCLUSION

Further studies are warranted to investigate whether in other SCI centres the risk of VTE in acute SCI patients is similarly associated with the risk factors identified in our study. A study exploring whether giving acute SCI patients of heavier weight a larger dose of chemical thromboprophylaxis is safe and efficacious is also warranted.

摘要

研究设计

一项回顾性医疗记录审计。

目的

调查急性创伤性脊髓损伤(SCI)后静脉血栓栓塞(VTE)事件的发生情况,以及VTE事件与一些假定风险因素之间的关联。

地点

位于澳大利亚墨尔本奥斯汀医院的澳大利亚维多利亚州全州性SCI服务机构(维多利亚脊髓服务机构)。

方法

对2010年至2013年期间入住VSCS的所有急性创伤性SCI患者进行回顾性电子病历档案审计。结局指标是VTE(深静脉血栓形成(DVT)、肺栓塞(PE)或两者皆有)的存在情况。还收集了关于SCI后VTE的各种既定和假定风险因素的数据。

结果

在患者住院期间,21.2%的急性SCI患者发生了VTE事件。发现VTE事件的存在与体重增加、男性、运动麻痹的完整性、住院时间(LOS)延长、相关骨盆或下肢骨折以及延迟入住全州性脊髓服务机构之间存在统计学上的显著关联。

结论

有必要进行进一步研究,以调查在其他SCI中心,急性SCI患者发生VTE的风险是否与我们研究中确定的风险因素类似相关。还需要进行一项研究,探讨给予体重较重的急性SCI患者更大剂量的化学血栓预防措施是否安全有效。

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