Department of Prehospital Emergency, Affiliated Hospital of Jining Medical University, Jining, Shandong, P. R. China.
Department of Critical Care Medicine, Affiliated Hospital of Jining Medical University, Jining, Shandong, P. R. China.
Medicine (Baltimore). 2024 Jun 14;103(24):e38423. doi: 10.1097/MD.0000000000038423.
The aim of this study is to describe the general information, disease and treatment of venous thromboembolism (VTE) in critically ill patients, to explore the characteristics of severe patients with deep venous VTE and provide clinical reference data for the prevention and treatment of VTE in critically ill patients. This study carried out a retrospective study on the medical records of patients who were treated in the intensive care unit of Affiliated Hospital of Jining Medical College from 2020 to 2022. The general data, general conditions, drug use, past history, VTE prevention measures, post-VTE conditions, and Padua risk score of 297 patients with VTE during the period of hospitalization in intensive care unit (ICU) were classified and statistically analyzed. A total of 297 including 171 male and 126 male patient medical records were included in the analysis, we compared multiple clinical indicators between male and female patients. Compared to women, male patients have a higher acute physiology and chronic health evaluation II score(APACHE-II score) (P = .027), a higher state of consciousness (P = .003), a higher rate of smoking and drinking history (P < .001), a lower rate of heart failure (P = .003) and chronic depression (P = .013), and a higher rate of recommended operations for male patients after VTE (P = .031). The prothrombin time (PT) (P = .041) and activated partial thromboplastin time (APTT) (P = .040) of male patients were significantly higher than those of female patients, while triglyceride (P = .009) and total cholesterol (TC) (P = .001) were significantly lower than those of female patients. The difference in D-dimer (P = .739) was not significant. This study shows that male and female patients with VTE in the ICU have significant differences in general characteristics, general clinical conditions, history of past illness, thrombosis character, and examination items, this may be the reason for the different rates of VTE between male and female patients in the ICU.
本研究旨在描述危重症患者静脉血栓栓塞症（VTE）的一般信息、疾病和治疗情况，探讨重症患者深静脉 VTE 的特点，为危重症患者 VTE 的预防和治疗提供临床参考数据。本研究对 2020 年至 2022 年在济宁医学院附属医院重症监护病房治疗的患者的病历进行了回顾性研究。对 297 例住院期间发生 VTE 的患者的一般资料、一般情况、用药情况、既往史、VTE 预防措施、VTE 后情况、Padua 风险评分进行分类，并进行统计学分析。共纳入分析 297 例患者病历，其中男 171 例，女 126 例，比较了男女患者的多项临床指标。与女性相比，男性患者的急性生理学和慢性健康评估 II 评分（APACHE-II 评分）更高（P=0.027），意识状态更高（P=0.003），吸烟和饮酒史发生率更高（P<0.001），心力衰竭发生率更低（P=0.003）和慢性抑郁症发生率较低（P=0.013），推荐男性患者 VTE 后进行手术的比例更高（P=0.031）。男性患者的凝血酶原时间（PT）（P=0.041）和活化部分凝血活酶时间（APTT）（P=0.040）明显高于女性患者，而甘油三酯（P=0.009）和总胆固醇（TC）（P=0.001）明显低于女性患者。D-二聚体（P=0.739）的差异无统计学意义。本研究表明，ICU 中 VTE 的男女患者在一般特征、一般临床情况、既往病史、血栓特征和检查项目方面存在显著差异，这可能是 ICU 中男女患者 VTE 发生率不同的原因。
