Department of Medicine, Ottawa Hospital Research Institute at the University of Ottawa, Ottawa, Canada.
Thromb Res. 2020 Jul;191:142-144. doi: 10.1016/j.thromres.2020.04.002. Epub 2020 Apr 30.
Venous thromboembolism (VTE) is a common complication among patients with cancer that is associated with significant morbidity, mortality and health care costs. There is a significant lack of awareness among health care providers and patients leading to delays in seeking medical attention or diagnosis when signs and symptoms of suspected VTE occur as well as underappreciation of potential benefits of different thromboprophylaxis options. Clinical prediction rules (e.g. Khorana risk score) can be used by clinicians to stratify patients according to their underlying risk of VTE. Low-molecular-weight-heparin and direct oral anticoagulants (rivaroxaban and apixaban) have been shown to be safe and effective thromboprophylactic options in this patient population. Health care providers should educate all patients regarding VTE and consider thromboprophylaxis in patients at higher risk of VTE complications. Decisions about thromboprophylaxis should be made with the patients and include a discussion about relative benefits and harms, costs and duration.
静脉血栓栓塞症（VTE）是癌症患者常见的并发症，与较高的发病率、死亡率和医疗保健成本相关。医疗保健提供者和患者对其认识不足，导致当出现 VTE 的可疑症状和体征时，寻求医疗关注或诊断的时间延迟，也未能充分认识到不同血栓预防选择的潜在益处。临床预测规则（例如，Khorana 风险评分）可用于对患者进行分层，根据他们的 VTE 潜在风险进行分层。低分子肝素和直接口服抗凝剂（利伐沙班和阿哌沙班）已被证明在这类患者人群中是安全且有效的血栓预防选择。医疗保健提供者应向所有患者教育 VTE 知识，并考虑对 VTE 并发症风险较高的患者进行血栓预防。血栓预防的决策应与患者共同做出，并包括讨论相对益处和危害、成本和持续时间。
