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多屏幕电子警报系统改善住院癌症患者的恰当药物预防:单中心经验。

Improvement of appropriate pharmacological prophylaxis in hospitalised cancer patients with a multiscreen e-alert system: a single-centre experience.

机构信息

Hematology Service, University Clinic of Navarra, Av. Pío XII 36, 31008, Pamplona, Spain.

Oncology Department, University Clinic of Navarra, Pamplona, Spain.

出版信息

Clin Transl Oncol. 2019 Jun;21(6):805-809. doi: 10.1007/s12094-018-1986-1. Epub 2018 Nov 16.

DOI:10.1007/s12094-018-1986-1
PMID:30446983
Abstract

PURPOSE

Thromboprophylaxis use among medical inpatients, including cancer patients, is suboptimal. We aimed to evaluate the impact of a novel multiscreen version (v2.0) of an e-alert system for VTE prevention in hospitalised cancer medical patients compared to the original software.

METHODS

Prospective study including 989 consecutive adult cancer patients with high-risk of VTE. Patients were followed-up 30 days post-discharge. Two periods were defined, according to the operative software.

RESULTS

E-alert v2.0 was associated with an increase in the use of LMWH prophylaxis (65.5% vs. 72.0%); risk difference (95% CI) 0.064 (0.0043-0.12). Only 16% of patients in whom LMWH prophylaxis was not prescribed lacked a contraindication. No significant differences in the rates of VTE (2.9% vs. 3.2%) and major bleeding (2.7% vs. 4.0%) were observed.

CONCLUSIONS

E-alert v2.0 further increased the use of appropriate thromboprophylaxis in hospitalised cancer patients, although was not associated with a reduction in VTE incidence.

摘要

目的

住院患者(包括癌症患者)的血栓预防用药并不理想。本研究旨在评估与原始软件相比,新型多屏幕版(v2.0)电子警报系统对预防住院癌症患者静脉血栓栓塞症(VTE)的影响。

方法

前瞻性研究纳入了 989 例有 VTE 高风险的成年癌症患者。患者在出院后 30 天内进行随访。根据使用的软件,定义了两个时期。

结果

与原始软件相比,e-alert v2.0 增加了低分子肝素(LMWH)预防的使用率(65.5% vs. 72.0%);差异率(95%CI)为 0.064(0.0043-0.12)。只有 16%的未开具 LMWH 预防药物的患者不存在禁忌证。VTE(2.9% vs. 3.2%)和大出血(2.7% vs. 4.0%)的发生率没有显著差异。

结论

e-alert v2.0 进一步增加了住院癌症患者中适当的血栓预防用药,但与 VTE 发生率的降低无关。

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High incidence of venous thromboembolism despite electronic alerts for thromboprophylaxis in hospitalised cancer patients.尽管对住院癌症患者进行了电子血栓预防警报,但静脉血栓栓塞的发生率仍很高。
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