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住院患者静脉血栓栓塞症:发生率和血栓预防的充分性——一项回顾性研究。

Venous Thromboembolism Among Hospitalized Patients: Incidence and Adequacy of Thromboprophylaxis - A Retrospective Study.

机构信息

Department of Medicine, Hamad Medical Corporation, Doha, Qatar.

Clinical Medicine, Weill Cornell Medicine -Qatar, Doha, Qatar.

出版信息

Vasc Health Risk Manag. 2022 Jul 24;18:575-587. doi: 10.2147/VHRM.S370344. eCollection 2022.

Abstract

PURPOSE

We aimed to determine the incidence of venous thromboembolism among hospitalized patients in Qatar as well as to analyze the adequacy of VTE assessment and prophylaxis in hospitalized patients.

DESIGN

Retrospective observational study.

SETTING

Four hospitals under Hamad Medical Corporation, Qatar.

PARTICIPANTS

Patients over the age of 18 who were hospitalized between January 2015 and December 2019 and developed venous thromboembolism during hospitalization or within a month after discharge were included.

RESULTS

During the study period, 641,994 individuals were admitted to hospitals. The inclusion criteria were satisfied by 209 of them. The mean age was 51.25 years and 54.5% were males. Hypertension and diabetes mellitus were the most common comorbidities found in the overall group. The incidence of VTE was 32.55 [95% CI 28.4, 37.3] per 100,000 admission per year [0.032%]. The annual incidence was least in 2015 (17.8 per 100,000 admissions) and highest in 2018 (44.4 per 100,000 admissions). Eighty-six subjects had DVT, and 109 had PE, whereas 14 had both. And, 67.5% of the patients developed VTE during admission while, 32.5% developed within 1 month of discharge. Moreover, 22.9% of the patients with PE developed pulmonary embolism after discharge from the hospital. VTE assessment was performed on 64.7% of the patients, and 69.7% received VTE prophylaxis in accordance with guidelines.

CONCLUSION

Although the occurrence of VTE among hospitalized patients in Qatar is low, healthcare providers need additional education and knowledge of VTE assessment and prophylaxis to follow guidelines for all patients at the time of admission. Furthermore, risk assessment for VTE should be done for all patients at the time of discharge to decide on post-discharge prophylaxis so that incidence of VTE after discharge can be minimized. Future studies should focus on patients who developed VTE after discharge from the hospital as well as on various risk factors.

摘要

目的

我们旨在确定卡塔尔住院患者静脉血栓栓塞症(venous thromboembolism,VTE)的发生率,并分析住院患者 VTE 评估和预防的充分性。

设计

回顾性观察性研究。

地点

卡塔尔哈马德医疗公司的四家医院。

参与者

纳入年龄大于 18 岁、于 2015 年 1 月至 2019 年 12 月住院且在住院期间或出院后 1 个月内发生 VTE 的患者。

结果

研究期间,共有 641994 人住院。其中 209 人符合纳入标准。患者的平均年龄为 51.25 岁,54.5%为男性。高血压和糖尿病是总体人群中最常见的合并症。VTE 的发生率为每年每 100000 人 32.55 [95%CI 28.4,37.3] [0.032%]。2015 年的年发生率最低(每 100000 人 17.8),2018 年的年发生率最高(每 100000 人 44.4)。86 例患者有 DVT,109 例患者有 PE,14 例患者同时有 DVT 和 PE。67.5%的患者在住院期间发生 VTE,32.5%的患者在出院后 1 个月内发生 VTE。此外,22.9%的 PE 出院后发生肺栓塞。对 64.7%的患者进行了 VTE 评估,根据指南,69.7%的患者接受了 VTE 预防。

结论

尽管卡塔尔住院患者 VTE 的发生率较低,但医疗保健提供者需要更多的 VTE 评估和预防方面的教育和知识,以便在入院时为所有患者遵循指南。此外,应在出院时对所有患者进行 VTE 风险评估,以决定出院后预防措施,从而使出院后 VTE 的发生率降至最低。未来的研究应关注出院后发生 VTE 的患者以及各种危险因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2ecf/9333096/1e3ef8ed5bda/VHRM-18-575-g0001.jpg

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