Wang Xiao, Wang Jing, Zhang Xiaoming, Zhang Xuemin, Li Qingle, Li Wei, Jiang Jingjun, Jiao Yang, Zhang Tao
Department of Vascular Surgery, Peking University People's Hospital, Peking University, Beijing, China.
Department of Vascular Surgery, Peking University People's Hospital, Peking University, Beijing, China.
Ann Vasc Surg. 2025 Jun;115:3-12. doi: 10.1016/j.avsg.2024.12.072. Epub 2025 Jan 31.
This study aimed to evaluate the demographic characteristics and changing trends in the incidence of hospital-acquired lower extremity deep venous thrombosis (HA-LEDVT) in Chinese inpatients over the course of 15 years.
We performed a retrospective analysis of the HA-LEDVT events in a medical center between January 1, 2007, and December 31, 2021.
A total of 846,347 eligible patients were analyzed. The overall incidence of HA-LEDVT was 2.53 per 1,000 admissions. The incidence was 0.22 and 4.20 per 1,000 admissions in 2007 and 2017, respectively (P < 0.01). Medical patients had a higher incidence of HA-LEDVT than surgical patients (3.19 vs. 2.14 per 1,000 admissions; P < 0.01). The incidence of HA-LEDVT increased from 0.28 to 11.90 per 1,000 admissions for those aged 17-29 years and 80-89 years, respectively (P < 0.01). The increase in HA-LEDVT incidence mainly occurred in patients aged ≥60 years. The median length of stay of HA-LEDVT patients was longer than that of other eligible patients (17 vs. 7 days; P < 0.01). Most of the HA-LEDVT events (77.8%) were diagnosed between hospital day 3 and 15, and the time from admission to HA-LEDVT diagnosis decreased by year. The rate of vascular surgery consultation for diagnosed or suspected HA-LEDVT and HA-LEDVT-related discharge instructions both decreased by half gradually over the 15 years of this study. Isolated distal deep vein thrombosis (DVT) accounted for 83.3% of all HA-LEDVT events, and the proportion increased significantly from 62.5% in 2007 to 88.7% in 2021 (P < 0.01).
The incidence of HA-LEDVT has been high in the Chinese population. More high-quality prospective studies are needed to guide prevention of HA-LEDVTs.
本研究旨在评估15年间中国住院患者医院获得性下肢深静脉血栓形成(HA-LEDVT)的人口统计学特征及发病率变化趋势。
我们对2007年1月1日至2021年12月31日期间某医疗中心的HA-LEDVT事件进行了回顾性分析。
共分析了846347例符合条件的患者。HA-LEDVT的总体发病率为每1000例入院患者2.53例。2007年和2017年的发病率分别为每1000例入院患者0.22例和4.20例(P<0.01)。内科患者的HA-LEDVT发病率高于外科患者(每1000例入院患者分别为3.19例和2.14例;P<0.01)。17至29岁和80至89岁患者的HA-LEDVT发病率分别从每1000例入院患者0.28例增至11.90例(P<0.01)。HA-LEDVT发病率的增加主要发生在60岁及以上患者中。HA-LEDVT患者的中位住院时间长于其他符合条件的患者(17天对7天;P<0.01)。大多数HA-LEDVT事件(77.8%)在住院第3天至15天之间被诊断出来,从入院到HA-LEDVT诊断的时间逐年缩短。在本研究的15年中,针对已诊断或疑似HA-LEDVT的血管外科会诊率以及与HA-LEDVT相关的出院指导率均逐渐下降了一半。孤立性远端深静脉血栓形成(DVT)占所有HA-LEDVT事件的83.3%,该比例从2007年的62.5%显著增至2021年的88.7%(P<0.01)。
中国人群中HA-LEDVT的发病率一直较高。需要更多高质量的前瞻性研究来指导HA-LEDVT的预防。