Rowling Sacha C, Fløjstrup Marianne, Henriksen Daniel Pilsgaard, Viberg Bjarke, Hallenberg Christian, Lindholt Jes Sanddal, Alberg-Fløjborg Andreas, Nanayakkara Prabath W B, Brabrand Mikkel
Odense University Hospital, University of Southern Denmark, Odense, Denmark.
Amsterdam University Medical Center, Location VU University Medical Centre, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
ERJ Open Res. 2022 Feb 28;8(1). doi: 10.1183/23120541.00535-2021. eCollection 2022 Jan.
Arterial punctures (APs) for arterial blood gas (ABG) analyses are much-used medical procedures. To date, no large studies have been conducted on the major complication rate of APs. We aimed to describe the risk of major complications within 7 days after puncture and investigate whether using antithrombotic medication affected this.
We included all APs performed for ABG analysis at three Danish hospitals from January 1, 1993 to February 25, 2013. We excluded APs ordered by the anaesthesiology department, intensive care unit (ICU) or in patients <18 years old. Data on the patient level were extracted from the Danish National Patient Registry, Danish Civil Registration System and Odense Pharmaco-Epidemiologic Database (OPED), the latter providing us with information on antithrombotic medication. Initially, two clinicians compiled a list with all procedures and diagnoses that could possibly be a consequence of APs. The selected procedures and diagnoses were further categorised independently by three surgeons and used to indicate the complication rate.
We analysed 473 327 APs and found 669 (0.14%, 95% CI 0.13-0.15) APs led to major complications: embolisms or thrombosis (49.0%), aneurysms (15.4%), nerve damage (1.5%), arteriovenous fistulas (0.6%) or of another kind (33.5%). The identified major complication rates in patients on antithrombotic medication were increased (OR 1.31, 95% CI 1.07-1.61).
APs for ABG analyses are safe procedures. The major complication rate within 7 days was 0.14% (95% CI 0.13-0.15). Patients on antithrombotic medication carry an increased risk of developing major complications.
用于动脉血气（ABG）分析的动脉穿刺（AP）是常用的医疗操作。迄今为止，尚未针对AP的主要并发症发生率开展大型研究。我们旨在描述穿刺后7天内发生主要并发症的风险，并调查使用抗血栓药物是否会对此产生影响。
我们纳入了1993年1月1日至2013年2月25日在丹麦三家医院进行的所有用于ABG分析的AP。我们排除了麻醉科、重症监护病房（ICU）下达的AP或18岁以下患者的AP。患者层面的数据从丹麦国家患者登记处、丹麦民事登记系统和欧登塞药物流行病学数据库（OPED）中提取，后者为我们提供了抗血栓药物的信息。最初，两名临床医生编制了一份可能由AP导致的所有操作和诊断的清单。选定的操作和诊断由三名外科医生进一步独立分类，并用于表明并发症发生率。
我们分析了473327次AP，发现669次（0.14%，95%CI 0.13 - 0.15）AP导致了主要并发症：栓塞或血栓形成（49.0%）、动脉瘤（15.4%）、神经损伤（1.5%）、动静脉瘘（0.6%）或其他类型（33.5%）。使用抗血栓药物的患者中确定的主要并发症发生率有所增加（OR 1.31，95%CI 1.07 - 1.61）。
用于ABG分析的AP是安全的操作。7天内的主要并发症发生率为0.14%（95%CI 0.13 - 0.15）。使用抗血栓药物的患者发生主要并发症的风险增加。
