Sartori Michelangelo, Fiocca Miriam, Soldati Mario, Borgese Laura, Favaretto Elisabetta, Cosmi Benilde
Angiology and Blood Coagulation Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy.
Department of Medical and Surgical Sciences, University of Bologna, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy.
Hematol Rep. 2024 Sep 25;16(4):568-578. doi: 10.3390/hematolrep16040055.
Hospital-acquired deep vein thrombosis (DVT) is an important cause of morbidity and mortality.
The purpose of this study was to evaluate the prevalence of proximal lower limb DVT and isolated distal DVT (IDDVT) and their relationship to the Padua Prediction Score (PPS) in acutely ill, hospitalized patients.
In a single-center cross-sectional study, all inpatients from medical departments with suspected lower-extremity DVT were evaluated with whole-leg ultrasonography during 183 days from 2016 to 2017.
Among the 505 inpatients (age 78.0 ± 13.3, females 59.2%) from medical departments, 204 (40.2%) had PPS ≥ 4, but only 54.4% of them underwent pharmacological thrombo-prophylaxis. Whole-leg ultrasonography detected 47 proximal DVTs (9.3%) and 65 IDDVTs (12.8%). Proximal DVT prevalence was higher in patients with high PPS vs. those with low PPS (12.7% vs. 7.0% = 0.029, respectively), whereas IDDVT prevalence was similar in patients with high and low PPS (14.7% vs. 11.6% = 0.311, respectively). The area under the receiver operating curve (AUC) for the PPS was 0.62 ± 0.03 for all DVTs, 0.64 ± 0.04 for proximal DVTs, and 0.58 ± 0.04 for IDDVTs.
In hospitalized patients, IDDVT had similar prevalence regardless of PPS risk stratification. Adherence to thrombo-prophylaxis in patients was still far from optimal.
医院获得性深静脉血栓形成（DVT）是发病和死亡的重要原因。
本研究旨在评估急性病住院患者下肢近端DVT和孤立性远端DVT（IDDVT）的患病率及其与帕多瓦预测评分（PPS）的关系。
在一项单中心横断面研究中，对2016年至2017年183天期间内科疑似下肢DVT的所有住院患者进行全腿超声检查。
在内科的505例住院患者（年龄78.0±13.3岁，女性占59.2%）中，204例（40.2%）PPS≥4，但其中只有54.4%接受了药物血栓预防。全腿超声检查发现47例近端DVT（9.3%）和65例IDDVT（12.8%）。高PPS患者的近端DVT患病率高于低PPS患者（分别为12.7%和7.0%， = 0.029），而高PPS和低PPS患者中的IDDVT患病率相似（分别为14.7%和11.6%， = 0.311）。PPS的受试者工作特征曲线下面积（AUC）对于所有DVT为0.62±0.03，对于近端DVT为0.64±0.04，对于IDDVT为0.58±0.04。
在住院患者中，无论PPS风险分层如何，IDDVT的患病率相似。患者对血栓预防的依从性仍远未达到最佳状态。
