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住院患者静脉血栓栓塞风险筛查的益处与必要性:一项系统评价

The Benefits and Imperative of Venous Thromboembolism Risk Screening for Hospitalized Patients: A Systematic Review.

作者信息

Bakhsh Ebtisam

机构信息

Clinical Sciences Department, College of Medicine, Princess Nourah bint Abdulrahman University, Riyadh 11671, Saudi Arabia.

出版信息

J Clin Med. 2023 Nov 9;12(22):7009. doi: 10.3390/jcm12227009.

Abstract

Venous thromboembolism (VTE) is a major preventable condition in hospitalized patients globally. This systematic review evaluates the effectiveness and clinical significance of venous thromboembolism (VTE) risk-screening protocols in preventing VTE events among hospitalized patients. Databases, including PubMed, Embase and Cochrane, were searched without date limits for studies comparing outcomes between hospitalized patients who did and did not receive VTE risk screening using standard tools. Twelve studies, enrolling over 139,420 patients, were included. Study quality was assessed using the ROBVIS tool. The results were summarized narratively. The findings show significant benefits of using VTE risk screening versus usual care across various outcomes. Using recommended tools, like Caprini, Padua and IMPROVE, allowed for the accurate identification of high-risk patients who benefited most from prevention. Formal screening was linked to much lower VTE rates, shorter hospital stays, fewer deaths and better use of preventive strategies matched to estimated clot risk. This review calls for the widespread adoption of VTE risk screening as an important safety step for at-risk hospital patients. More high-quality comparative research is needed to validate screening tools in different settings and populations. In summary, VTE risk screening is essential for healthcare systems to reduce life-threatening VTE events and improve patient outcomes through properly targeted preventive methods.

摘要

静脉血栓栓塞症(VTE)是全球住院患者中一种主要的可预防疾病。本系统评价评估了静脉血栓栓塞症(VTE)风险筛查方案在预防住院患者发生VTE事件方面的有效性和临床意义。检索了包括PubMed、Embase和Cochrane在内的数据库,不限日期查找比较使用标准工具进行VTE风险筛查和未进行筛查的住院患者结局的研究。纳入了12项研究,涉及超过139420名患者。使用ROBVIS工具评估研究质量。结果采用叙述性总结。研究结果表明,与常规护理相比,使用VTE风险筛查在各种结局方面都有显著益处。使用推荐工具,如Caprini、Padua和IMPROVE,能够准确识别出从预防中获益最大的高危患者。正式筛查与更低的VTE发生率、更短的住院时间、更少的死亡以及更好地根据估计的血栓风险匹配使用预防策略相关。本评价呼吁广泛采用VTE风险筛查,将其作为高危住院患者的一项重要安全措施。需要更多高质量的比较研究来验证不同环境和人群中的筛查工具。总之,VTE风险筛查对于医疗系统通过适当的针对性预防方法减少危及生命的VTE事件和改善患者结局至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f105/10672497/da8d12b15c9d/jcm-12-07009-g001.jpg

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