硬膜外导管与创伤后静脉血栓栓塞风险增加有关。
Epidural catheters are associated with an increased risk of venous thromboembolism in trauma.
机构信息
Division of Traumatology, Surgical Critical Care and Emergency Surgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.
Division of Acute Care Surgery and Trauma, University of Rochester Medical Center, Rochester, NY, USA.
出版信息
J Thromb Thrombolysis. 2020 Apr;49(3):420-425. doi: 10.1007/s11239-019-02024-3.
Little is known about the association between epidural catheters (EC) and venous thromboembolism (VTE) in trauma. We sought to study this association and hypothesized that trauma patients with EC were more likely to develop VTE. Using the Pennsylvania Trauma Outcomes Study (PTOS) registry, we identified all adult trauma patients (age ≥ 18) admitted for at least 2 days between 1/2013 and 12/2017. Baseline characteristics and outcome variables were compared between patients who underwent EC placement and those who did not. The primary outcome was development of VTE. 147,721 patients met inclusion criteria; 2247 (1.5%) developed a VTE. Patients were mostly white (85%), male (56%), with blunt trauma (94%). 776 (0.5%) had an EC placed. Patients who underwent EC placement were more likely to develop a VTE (2.8% vs. 1.5%, p = 0.003). After adjusting for covariates, patients with EC were 1.6 times more likely to develop VTE (95% CI 1.1-2.5). The overall rate of VTE was low and associated with the use of EC. Future work should focus on determining the underlying mechanisms.
关于创伤患者硬膜外导管（EC）与静脉血栓栓塞（VTE）之间的关联，我们知之甚少。我们试图研究这种关联，并假设接受 EC 治疗的创伤患者更有可能发生 VTE。我们使用宾夕法尼亚创伤结局研究（PTOS）登记处，确定了 2013 年 1 月至 2017 年 12 月期间至少住院 2 天的所有成年创伤患者（年龄≥18 岁）。比较了接受 EC 置管和未接受 EC 置管的患者的基线特征和结局变量。主要结局是 VTE 的发生。147721 名患者符合纳入标准；2247 名（1.5%）发生 VTE。患者主要为白人（85%），男性（56%），钝性创伤（94%）。776 名（0.5%）患者放置了 EC。接受 EC 置管的患者发生 VTE 的可能性更高（2.8%比 1.5%，p=0.003）。调整混杂因素后，EC 患者发生 VTE 的可能性增加 1.6 倍（95%CI 1.1-2.5）。VTE 的总体发生率较低，与 EC 的使用有关。未来的研究应重点确定潜在的机制。
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