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.
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.
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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