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多学科团队减少老年骨科患者围手术期血栓形成事件

MDT Reduces Perioperative Thrombotic Events in Elderly Orthopedic Patients.

作者信息

Chen Tonghua, Lei Xiaojun, Tian Jingwei, Mai Haochen, Yu Yuanfang, Wu Wenxia, Wen Liqiang, Saw Phei Er, Zhang Meng

机构信息

Department of General Practice, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, Guangdong, People's Republic of China.

Department of General Practice, Shenshan Medical Center, Sun Yat-sen Memorial Hospital, Shanwei, Guangdong, People's Republic of China.

出版信息

J Multidiscip Healthc. 2025 Aug 8;18:4859-4870. doi: 10.2147/JMDH.S519129. eCollection 2025.

Abstract

PURPOSE

To minimize the occurrence of acute thromboembolic events in elderly patients during the perioperative period and prevent adverse clinical outcomes, this study explores an efficient, and precise approach to the formulation of antithrombotic regimens under a multidisciplinary team (MDT) consultation model.

PATIENTS AND METHODS

This single-center retrospective study included elderly patients on long-term antithrombotic therapy who underwent orthopedic surgery in our hospital between January 2019 and May 2023. Patients were divided into two groups: the MDT group and the non-MDT group. The incidence of thrombotic and bleeding-related adverse events during the perioperative period was observed and compared between the two groups.

RESULTS

A total of 436 patients were enrolled, among whom 32 (7.3%) experienced thromboembolic adverse events. The incidence was significantly lower in the MDT group compared to the non-MDT group (3.3% vs 8.9%, P = 0.043). Logistic regression analysis identified several significant factors associated with thromboembolic adverse events, including: type of antithrombotic medication (OR=1.508, P=0.009) and postoperative ICU transfer (OR=6.390, P=0.029) were positively associated with thrombotic events; multidisciplinary team (OR=0.215, P=0.011) demonstrated a protective effect (negative association).

CONCLUSION

The multidisciplinary consultation model improves perioperative antithrombotic management strategies for elderly patients, contributing to a reduced incidence of thrombotic events in orthopedic surgeries for this population.

摘要

目的

为尽量减少老年患者围手术期急性血栓栓塞事件的发生并预防不良临床结局,本研究探索在多学科团队(MDT)会诊模式下制定抗血栓治疗方案的高效、精准方法。

患者与方法

本单中心回顾性研究纳入了2019年1月至2023年5月期间在我院接受骨科手术且正在接受长期抗血栓治疗的老年患者。患者分为两组:MDT组和非MDT组。观察并比较两组围手术期血栓形成和出血相关不良事件的发生率。

结果

共纳入436例患者,其中32例(7.3%)发生血栓栓塞不良事件。MDT组的发生率显著低于非MDT组(3.3%对8.9%,P = 0.043)。逻辑回归分析确定了与血栓栓塞不良事件相关的几个重要因素,包括:抗血栓药物类型(OR = 1.508,P = 0.009)和术后转入重症监护病房(OR = 6.390,P = 0.029)与血栓形成事件呈正相关;多学科团队(OR = 0.215,P = 0.011)显示出保护作用(负相关)。

结论

多学科会诊模式改善了老年患者围手术期抗血栓管理策略,有助于降低该人群骨科手术中血栓形成事件的发生率。

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