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作者信息

Lopes Bruno Abdala Candido, Teixeira Isabela Pizzatto, de Souza Taynara Dantas, Tafarel Jean Rodrigo

机构信息

Pontifícia Universidade Católica do Paraná - PUCPR, Departamento de Clínica Médica, Curitiba, PR, Brasil.

出版信息

J Vasc Bras. 2017 Jul-Sep;16(3):199-204. doi: 10.1590/1677-5449.008516.

Abstract

BACKGROUND

Although prophylaxis to prevent venous thromboembolism is recommended, it is rarely systematically performed in hospitalized patients.

OBJECTIVE

To investigate whether hospitalized patients are given the correct VTE prophylaxis prescription by the physician responsible for them while in hospital, analyzed by risk category.

METHODS

This was a cross-sectional study based on analysis of medical records for patients admitted to the Hospital Santa Casa de Misericórdia, Curitiba, PR, Brazil, from March 20 to May 25, 2015. Patients on anticoagulants or with active bleeding were excluded. The following variables were analyzed: sex, age, type of healthcare coverage, specialty responsible for the patient, and patients’ risk factors to classify them as at high, moderate, or low risk of VTE. Use or not of prophylaxis was compared across prescriptions made by clinical and surgical specialties, between patients treated on the Brazilian National Health Service (SUS - Sistema Único de Saúde) and private health insurance, and according to patients’ risk of VTE.

RESULTS

Eight of the 78 patients assessed met exclusion criteria. The remaining 70 eligible patients had a mean age of 56.9 years, 41 were male, 62 were treated on the SUS, 31 were treated by clinicians, and 39 were treated by surgeons. Just 46 (65.71%) patients were given prophylaxis for VTE. Among the clinical patients, 29 (93.5%) were given prophylaxis, against 17 (43.6%) in the surgical group (p < 0.001). Moderate and high risk clinical patients were more likely to be given prophylaxis than surgical patients (p < 0.001 and p = 0.002). There were no differences with relation to type of healthcare coverage (SUS vs. private healthcare).

CONCLUSIONS

At the Hospital Santa Casa de Misericórdia in Curitiba, surgical patients are less well protected from thromboembolic events than clinical patients.

摘要

背景

尽管推荐进行预防静脉血栓栓塞的措施,但在住院患者中很少系统地实施。

目的

调查负责住院患者的医生在患者住院期间是否根据风险类别给予正确的静脉血栓栓塞症(VTE)预防处方。

方法

这是一项横断面研究,基于对2015年3月20日至5月25日入住巴西巴拉那州库里蒂巴圣卡塔琳娜慈善医院的患者病历进行分析。排除正在接受抗凝治疗或有活动性出血的患者。分析了以下变量:性别、年龄、医保类型、负责患者的专科,以及将患者分类为VTE高、中、低风险的风险因素。比较了临床和外科专科开出的处方中预防措施的使用情况、巴西国家卫生服务体系(SUS)和私人医疗保险治疗的患者之间的情况,以及根据患者的VTE风险情况。

结果

78例评估患者中有8例符合排除标准。其余70例符合条件的患者平均年龄为56.9岁,41例为男性,62例接受SUS治疗,31例由临床医生治疗,39例由外科医生治疗。仅46例(65.71%)患者接受了VTE预防措施。在临床患者中,29例(93.5%)接受了预防措施,而外科组为17例(43.6%)(p<0.001)。中度和高风险的临床患者比外科患者更有可能接受预防措施(p<0.001和p = 0.002)。医保类型(SUS与私人医保)方面没有差异。

结论

在库里蒂巴的圣卡塔琳娜慈善医院,外科患者比临床患者在预防血栓栓塞事件方面受到的保护更少。

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J Vasc Bras. 2017 Jul-Sep;16(3):199-204. doi: 10.1590/1677-5449.008516.

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[Recommendations for the management of pulmonary thromboembolism, 2010].
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