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在外科医生总呼吁采取行动前后美国住院静脉血栓栓塞症的趋势。

Trends of Inpatient Venous Thromboembolism in United States Before and After the Surgeon General's Call to Action.

机构信息

Division of Hematology-Oncology, University of Kansas Medical Center, Kansas City, Kansas.

Division of Hematology-Oncology, Baystate Medical Center, Springfield, Massachusetts.

出版信息

Am J Cardiol. 2019 Sep 15;124(6):960-965. doi: 10.1016/j.amjcard.2019.06.015. Epub 2019 Jun 26.

DOI:10.1016/j.amjcard.2019.06.015
PMID:31324359
Abstract

Venous thromboembolism (VTE) is an important cause of morbidity and mortality in the United States (US). The increasing rates of VTE in the US resulted in the surgeon general issuing a call to action to reduce VTE in 2008. The objective of our study was to analyze the national trends of inpatient VTE in the US from 2004 to 2013 (5 years before and after 2008). We used the dataset National Inpatient Sample, Healthcare Cost and Utilization Project and measured trends of inpatient VTE by annual % change using joinpoint regression software. From 2004 to 2013 the National Inpatient Sample contained data on 78 million hospitalizations (weighted n = 385 million). In these 1.6 million had a diagnosis of VTE (2.0%, weighted n = 7.7 million) including 1.2 million with deep venous thrombosis (DVT) (1.53%, weighted n = 5.9 million) and 588,878 with pulmonary embolism (PE) (0.74%, weighted n = 2.8 million). Joinpoint regression analysis showed that rates of DVT and PE are increasing consistently from 2004 to 2013(1.27% to 1.80% for DVT and 0.52% to 0.92% for PE). The increasing rates of DVT and PE were consistent in all subgroups except few exceptions. In conclusion inpatient VTE rates continue to rise even after 5 years from the surgeon general's a call to action except in certain high-risk patients. Further research is needed to curb the VTE in patients especially among those perceived to be at lower risk of VTE.

摘要

静脉血栓栓塞症(VTE)是美国发病率和死亡率的重要原因。美国 VTE 发病率不断上升,导致外科医生于 2008 年呼吁采取行动降低 VTE。我们的研究目的是分析 2004 年至 2013 年(2008 年前 5 年和后 5 年)美国住院患者 VTE 的全国趋势。我们使用国家住院患者样本数据集、医疗保健成本和利用项目,使用 joinpoint 回归软件通过年度%变化来衡量住院 VTE 的趋势。2004 年至 2013 年,国家住院患者样本包含 7800 万例住院数据(加权 n=3.85 亿)。在这 1600 万例中,有 160 万例患有 VTE(2.0%,加权 n=770 万),包括 120 万例深静脉血栓形成(DVT)(1.53%,加权 n=590 万)和 588878 例肺栓塞(PE)(0.74%,加权 n=280 万)。Joinpoint 回归分析显示,2004 年至 2013 年 DVT 和 PE 的发病率持续上升(DVT 从 1.27%上升到 1.80%,PE 从 0.52%上升到 0.92%)。除了少数例外,所有亚组中 DVT 和 PE 的发病率都呈持续上升趋势。总之,即使在外科医生呼吁采取行动 5 年后,住院患者 VTE 率仍在上升,除了某些高危患者。需要进一步研究以遏制患者的 VTE,尤其是那些被认为 VTE 风险较低的患者。

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