Maurizot A, Bura-Rivière A, Gritli K, Bertoletti L, Hernández-Blasco L, Ciammaichella M, Díaz-Pedroche M C, Alfonso M, Lorente M A, Monreal M
Service de médecine vasculaire, hôpital de Rangueil, CHU de Toulouse, 1, avenue du Professeur-Jean-Poulhès, TSA 50032, 31059 Toulouse cedex 9, France; Consultations de médecine vasculaire, Centre cardiologique du Nord, 32-36, rue des Moulins-Gémeaux, 93200 Saint-Denis, France.
Service de médecine vasculaire, hôpital de Rangueil, CHU de Toulouse, 1, avenue du Professeur-Jean-Poulhès, TSA 50032, 31059 Toulouse cedex 9, France.
J Med Vasc. 2017 Feb;42(1):6-13. doi: 10.1016/j.jdmv.2017.01.002. Epub 2017 Apr 18.
Many national and international guidelines have been established for venous thromboembolic disease (VTE). Homogeneous management practices could be expected in the different European countries. To verify this hypothesis, we compared practices in France, Italy and Spain.
We used data from the international RIETE registry to compare VTE management between France, Italy and Spain.
From 2001 January to 2011 January, patients were consecutively included in France (n=1548), Italy (n=2083) and Spain (29,824). All patients received anticoagulant treatment. Low molecular-weight heparin (LMWH) was the most frequently used drug as initial therapy in all three countries, but unfractionated heparin (UFH) was more frequently used in France and Italy than in Spain. In France, the proportion of patients receiving LMWH was lower than the proportion of patients with active cancer (cancer 22.5 %, long-term treatment with LMWH 17.4 %). A vena cava filter was significantly more frequently used in France (5.5 % in France, 3.2 % in Italy and 2 % in Spain, P<0.0001). High bleeding risk because of surgery with recent thromboembolic disease was the most frequent indication in France and Italy for vena cava filter placement (36.4 %, and 31.3 %, respectively).
Despite the publication of national and international guidelines, VTE management differs among the three major European countries included in the RIETE registry, France, Italy and Spain.
针对静脉血栓栓塞性疾病（VTE），已经制定了许多国家和国际指南。不同的欧洲国家有望采用统一的管理方法。为了验证这一假设，我们比较了法国、意大利和西班牙的管理方法。
我们使用国际RIETE注册中心的数据，比较法国、意大利和西班牙的VTE管理情况。
从2001年1月至2011年1月，法国（n = 1548）、意大利（n = 2083）和西班牙（29824）的患者被连续纳入研究。所有患者均接受抗凝治疗。低分子量肝素（LMWH）是所有三个国家最常作为初始治疗使用的药物，但普通肝素（UFH）在法国和意大利比在西班牙更常使用。在法国，接受LMWH治疗的患者比例低于患有活动性癌症的患者比例（癌症患者占22.5%，接受LMWH长期治疗的患者占17.4%）。法国使用下腔静脉滤器的频率明显更高（法国为5.5%，意大利为3.2%，西班牙为2%，P < 0.0001）。近期血栓栓塞性疾病手术后因出血风险高是法国和意大利放置下腔静脉滤器最常见的指征（分别为36.4%和31.3%）。
尽管发布了国家和国际指南，但RIETE注册中心纳入的三个主要欧洲国家，即法国、意大利和西班牙，在VTE管理方面存在差异。
