卡拉巴尔大学教学医院癌症患者的血栓形成风险评估、P-选择素与血栓预防应用情况，卡拉巴尔
Thrombotic Risk Assessment, P-Selectin, and Thromboprophylaxis Use Among, Cancer Patients at the University of Calabar Teaching Hospital, Calabar.
作者信息
Akaba Kingsley, Akaba Edakabasi, Oshatuyi Olukayode, Ssenkumba Brian
机构信息
Department of Haematology, University of Calabar, Calabar, Cross River State, Nigeria.
Department of Pathology, University of Calabar Teaching Hospital, Calabar, Cross River State, Nigeria.
出版信息
J Blood Med. 2024 Dec 14;15:501-512. doi: 10.2147/JBM.S478192. eCollection 2024.
BACKGROUND
Venous thromboembolism is the second leading cause of mortality among cancer patients. The Khorana Risk Assessment Score (KRAS) is widely acknowledged as the most validated tool in this context.
AIM
To assess the thrombotic risk in cancer patients using the modified Khorana Risk Assessment Score, examine the association between modified KRAS and soluble P-selectin levels, and document the utilization of thromboprophylaxis among cancer patients at the University of Calabar Teaching Hospital.
METHODS
This was a cross-sectional hospital-based recruiting 100 cancer patients. Seven millilitres of blood were collected for complete blood count and P-selectin assay. Continuous variables were expressed as mean and standard deviation, while categorical variables were summarized using frequencies. Chi-square was employed to compare VTE risk status across genders, different cancer types, and guideline compliance. The significance level was set at 0.05.
RESULTS
Participants age ranged from 19 to 87 years, with a male-to-female ratio of 1:1.6. The most common female cancer was Breast at 40.32% and prostate cancer at 65.79% was the most common in males. Seventy nine percent and 21% of participants had intermediate and high-risk modified KRAS scores respectively. The median level of soluble P-selectin among cancer patients was 23.00 within the interquartile range. Significant associations were observed between cancer types and sex, VTE risk assessment and cancer types, and cancer types and risk score.
CONCLUSION
The risk of VTE among cancer patients ranges from intermediate to high, going by the modified Khorana risk score irrespective of the P selectin level, with underutilization of thromboprophylaxis. There is little adherence to the Khorana score in our setting, hence the need for greater application and knowledge of this predictive score in clinical practice to improve outcomes and quality of life.
背景
静脉血栓栓塞是癌症患者死亡的第二大主要原因。在这种情况下，科拉纳风险评估评分（KRAS）被广泛认为是最有效的工具。
目的
使用改良的科拉纳风险评估评分评估癌症患者的血栓形成风险，研究改良的KRAS与可溶性P-选择素水平之间的关联，并记录卡拉巴尔大学教学医院癌症患者血栓预防的使用情况。
方法
这是一项基于医院的横断面研究，招募了100名癌症患者。采集7毫升血液进行全血细胞计数和P-选择素检测。连续变量以均值和标准差表示，分类变量用频率进行总结。采用卡方检验比较不同性别、不同癌症类型和指南依从性的VTE风险状态。显著性水平设定为0.05。
结果
参与者年龄在19至87岁之间，男女比例为1:1.6。最常见的女性癌症是乳腺癌，占40.32%，男性最常见的是前列腺癌，占65.79%。79%和21%的参与者分别具有中度和高风险的改良KRAS评分。癌症患者中可溶性P-选择素的中位数水平为23.00，四分位间距内。在癌症类型与性别、VTE风险评估与癌症类型以及癌症类型与风险评分之间观察到显著关联。
结论
根据改良的科拉纳风险评分，癌症患者发生VTE的风险从中度到高度不等，无论P选择素水平如何，血栓预防措施的使用不足。在我们的环境中对科拉纳评分的依从性较低，因此需要在临床实践中更多地应用和了解这个预测评分，以改善治疗效果和生活质量。
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