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整形外科中的静脉血栓栓塞预防

Venous Thromboembolism Prophylaxis in Plastic Surgery.

作者信息

Gupta Rohun, Bisht Chirag, Genova Rafaella, Ege Eliana, Chetta Matthew, Shaheen Kenneth

机构信息

Oakland University William Beaumont School of Medicine, Rochester, Michigan.

California Northstate University College of Medicine, Elk Grove, California.

出版信息

Eplasty. 2023 Dec 11;23:e78. eCollection 2023.

Abstract

BACKGROUND

In 2011, the American Society of Plastic Surgery (ASPS) formed the Venous Thromboembolism Task Force Report, which encouraged the use of the 2005 Caprini score and was amended in 2013. Still, there have been several studies that have questioned the validity of the Caprini score. As a result, the goal of this study is to present our experience with chemoprophylaxis in cosmetic patients compared with the current recommendations for venous thromboembolism VTE) chemoprophylaxis endorsed by the ASPS.

METHODS

A retrospective analysis was conducted in all patients operated on by a single surgeon from 2006 to 2016. Exclusion criteria were surgery length >6 hours, patients with known hypercoagulable states, or a personal history of deep vein thrombosis (DVT)/pulmonary embolism (PE). Demographic data were collected and analyzed.

RESULTS

There were 1272 patients from a single institution who met the inclusion criteria. We determined that 71% of patient VTE scores were in the high to highest risk categories (n = 657), median age was 46 years, 79% of the population was Caucasian, 35% of patients had a body mass index of overweight or obese, and the average length of stay was 1 day. The rate of VTE in our patient population was found to be 0.08% (1 patient), which was uncomplicated and resolved with conservative therapy.

CONCLUSIONS

This retrospective study found no significant difference in the incidence of VTE by providing chemophrophylaxis to patients without utilizing a scoring system. Our study suggests that the Caprini Scoring system might not be optimal in predicting VTE in patients undergoing aesthetic surgery.

摘要

背景

2011年,美国整形外科协会(ASPS)成立了静脉血栓栓塞特别工作组报告,该报告鼓励使用2005年的Caprini评分,并于2013年进行了修订。然而,仍有多项研究对Caprini评分的有效性提出质疑。因此,本研究的目的是介绍我们在美容患者中进行化学预防的经验,并与ASPS认可的当前静脉血栓栓塞(VTE)化学预防建议进行比较。

方法

对2006年至2016年由单一外科医生进行手术的所有患者进行回顾性分析。排除标准为手术时间>6小时、已知有高凝状态的患者或有深静脉血栓形成(DVT)/肺栓塞(PE)个人史的患者。收集并分析人口统计学数据。

结果

来自单一机构的1272名患者符合纳入标准。我们确定71%的患者VTE评分为高风险至最高风险类别(n = 657),中位年龄为46岁,79%的人群为白种人,35%的患者体重指数超重或肥胖,平均住院时间为1天。我们的患者群体中VTE发生率为0.08%(1例患者),该病例无并发症,通过保守治疗得以解决。

结论

这项回顾性研究发现,在不使用评分系统为患者提供化学预防的情况下,VTE发生率没有显著差异。我们的研究表明,Caprini评分系统在预测美容手术患者的VTE方面可能并非最佳。

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