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系统评价真实世界研究评估与深静脉血栓形成门诊管理相关的特征或设计以促进其管理的方案。

Systematic Review of Real-World Studies Evaluating Characteristics Associated With or Programs Designed to Facilitate Outpatient Management of Deep Vein Thrombosis.

机构信息

Department of Clinical Pharmacy and Outcomes Sciences, Medical University of South Carolina College of Pharmacy, Charleston, SC, USA.

出版信息

Clin Appl Thromb Hemost. 2018 Dec;24(9_suppl):301S-313S. doi: 10.1177/1076029618811082. Epub 2018 Nov 14.

Abstract

Select patients with acute deep vein thrombosis (DVT) can be managed as outpatients. We sought to conduct a systematic review of real-world studies describing either (1) the clinical characteristics associated with outpatient DVT treatment in all-comers or (2) emergency department (ED) programs designed to facilitate outpatient DVT treatment. MEDLINE and SCOPUS were searched (January 1, 2012, to May 1, 2018) to identify citations meeting the aforementioned criteria. Twenty-one real-world studies were included. The proportion of all-comer patients with DVT managed as outpatients was ≤50% in 11 of 15 studies. With the exception of younger age, no characteristics were consistently associated with outpatient treatment across the 13 studies reporting these characteristics. We identified 8 studies describing ED programs aimed at facilitating DVT outpatient treatment, all of which provided education and included measures to encourage early outpatient follow-up after ED discharge. In conclusion, the proportion of patients with DVT managed as outpatients across real-world studies was low. Several ED programs aimed at facilitating this treatment have been described. It is possible that programs similar to these will increase the proportion of patients with DVT that can be safely managed as outpatients.

摘要

选择患有急性深静脉血栓形成(DVT)的患者可以进行门诊治疗。我们旨在对描述以下两种情况的真实世界研究进行系统回顾:(1)所有患者门诊 DVT 治疗相关的临床特征,或(2)旨在促进门诊 DVT 治疗的急诊部(ED)方案。我们检索了 MEDLINE 和 SCOPUS(2012 年 1 月 1 日至 2018 年 5 月 1 日)以确定符合上述标准的参考文献。共纳入 21 项真实世界研究。在 15 项报告这些特征的研究中,有 11 项研究中所有 DVT 患者中门诊治疗的比例≤50%。除了年龄较小之外,在 13 项报告这些特征的研究中,没有任何特征与门诊治疗一致相关。我们确定了 8 项描述旨在促进 DVT 门诊治疗的 ED 方案的研究,所有这些方案都提供了教育,并采取措施鼓励 ED 出院后早期门诊随访。总之,在真实世界研究中,门诊治疗的 DVT 患者比例较低。已经描述了几个旨在促进这种治疗的 ED 方案。这些方案可能会增加可以安全进行门诊治疗的 DVT 患者的比例。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9700/6714833/f90b36d60c2b/10.1177_1076029618811082-fig1.jpg

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