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非肿瘤性泌尿外科住院患者院内静脉血栓栓塞症的发病率及危险因素:单中心经验

Incidence and risk factors of in-hospital venous thromboembolism in non-oncological urological inpatients: A single center experience.

作者信息

Wang Zhao, Li Kaixuan, Zhu Quan, Li Haozhen, Wu Ziqiang, Liu Xuesong, Tang Zhengyan

机构信息

Department of Urology, Xiangya Hospital, Central South University, Changsha, China.

Provincial Laboratory for Diagnosis and Treatment of Genitourinary System Disease, Changsha, China.

出版信息

Asian J Urol. 2023 Oct;10(4):546-554. doi: 10.1016/j.ajur.2021.11.007. Epub 2021 Nov 24.

Abstract

OBJECTIVE

To determine incidence and risk factors for venous thromboembolism (VTE) development of in-hospital VTE in urological inpatients who underwent non-oncological surgery in a tertiary hospital in China.

METHODS

Consecutive 1453 inpatients who were admitted to a non-oncological urological ward in the tertiary hospital from January 1, 2018 to December 31, 2018 were enrolled in the study, and the VTE events were diagnosed by ultrasound or computed tomographic pulmonary angiography. Patients' occurrence of VTE and characteristics which may contribute to the development of VTE were collected and analyzed as incidence and risk factors.

RESULTS

The incidence of VTE in non-oncological urological inpatients is 2.3%. In our cohort, patients who experienced previous VTE (adjusted odds ratios [aOR] 14.272, 95% CI 3.620-56.275), taking anticoagulants or antiplatelet agents before admission (aOR 10.181, 95% CI 2.453-42.256), D-dimer (max) ≥1 μg/mL (aOR 22.456, 95% CI 6.468-77.967), lower extremity swelling (aOR 10.264, 95% CI 2.242-46.994), chest symptoms (aOR 79.182, 95% CI 7.132-879.076), operation time of more than or equal to 180 min (aOR 10.690, 95% CI 1.356-84.300), and Caprini score (max) of more than or equal to 5 (aOR 34.241, 95% CI 1.831-640.235) were considered as risk factors for VTE.

CONCLUSION

In this study, we found that the incidence of VTE in non-oncological surgery was about 2.3%, which was higher than some previous studies. Risk factors could be used for early detection and diagnosis of VTE.

摘要

目的

确定中国一家三级医院中接受非肿瘤手术的泌尿外科住院患者院内静脉血栓栓塞症(VTE)发生的发生率及风险因素。

方法

纳入2018年1月1日至2018年12月31日在该三级医院非肿瘤泌尿外科病房连续收治的1453例住院患者,VTE事件通过超声或计算机断层扫描肺动脉造影诊断。收集并分析患者VTE的发生情况以及可能导致VTE发生的特征,作为发生率和风险因素。

结果

非肿瘤泌尿外科住院患者VTE的发生率为2.3%。在我们的队列中,既往有VTE病史的患者(调整比值比[aOR]为14.272,95%置信区间[CI]为3.620 - 56.275)、入院前服用抗凝剂或抗血小板药物的患者(aOR为10.181,95% CI为2.453 - 42.256)、D - 二聚体(最大值)≥1μg/mL的患者(aOR为22.456,95% CI为6.468 - 77.967)、下肢肿胀的患者(aOR为10.264,95% CI为2.242 - 46.994)、有胸部症状的患者(aOR为79.182,95% CI为7.132 - 879.076)、手术时间大于或等于180分钟的患者(aOR为10.690,95% CI为1.356 - 84.300)以及Caprini评分(最大值)大于或等于5分的患者(aOR为34.241,95% CI为1.831 - 640.235)被视为VTE的风险因素。

结论

在本研究中,我们发现非肿瘤手术中VTE的发生率约为2.3%,高于一些先前的研究。风险因素可用于VTE的早期检测和诊断。

相似文献

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[Clinical features of patients with venous thromboembolism: 177 case analysis in 10 years].[静脉血栓栓塞症患者的临床特征:10年177例病例分析]
Zhonghua Wei Zhong Bing Ji Jiu Yi Xue. 2019 Apr;31(4):453-457. doi: 10.3760/cma.j.issn.2095-4352.2019.04.016.

本文引用的文献

7
Venous thromboembolism prophylaxis in urology: A review.泌尿外科中的静脉血栓栓塞预防:综述
Int J Urol. 2017 Aug;24(8):589-593. doi: 10.1111/iju.13399. Epub 2017 Jul 25.

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