Risk factors for inpatient venous thromboembolism despite thromboprophylaxis.
Risk factors for inpatient venous thromboembolism despite thromboprophylaxis.
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DOI：
10.1016/j.thromres.2013.09.011
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发表时间：
2014-01
影响因子：
7.5
通讯作者：
Gage BF
中科院分区：
文献类型：
--
作者：
Wang TF;Wong CA;Milligan PE;Thoelke MS;Woeltje KF;Gage BF
静脉血栓栓塞（VTE）是医院中最常见的可预防的发病和死亡原因。充分的血栓预防措施大大降低了医院获得性静脉血栓栓塞的发生率;然而，一些住院患者即使接受了血栓预防措施，仍然会发生静脉血栓栓塞。与血栓预防失败相关的预测因素尚不清楚。在这项研究中，我们的目的是确定住院静脉血栓栓塞的危险因素，尽管血栓预防。我们进行了一项病例对照研究，以确定住院VTE的独立预测因素。在2010年1月至2011年5月期间从BJC医疗保健系统出院的患者中，我们将94例在接受血栓预防时发生院内VTE的病例与272例未发生VTE的对照组进行了匹配。按医院、患者年龄、出院月份和年份进行匹配。我们使用多变量条件Logistic回归来建立VTE预测模型。我们确定了尽管进行了血栓预防，但院内静脉血栓栓塞的5个独立风险因素：因颅脑手术住院、入住重症监护室、入院时白细胞计数> 13，000/mm 3、存在留置中心静脉导管和从长期护理机构入院。我们确定了五个与静脉血栓栓塞相关的危险因素，尽管在医院进行了血栓预防。通过识别这些高危患者，临床医生可以明智地开出积极的VTE预防措施，并对VTE的体征或症状保持警惕。
Venous thromboembolism (VTE) is the most common preventable cause of morbidity and mortality in the hospital. Adequate thromboprophylaxis has reduced the rate of hospital-acquired VTE substantially; however, some inpatients still develop VTE even when they are prescribed thromboprophylaxis. Predictors associated with thromboprophylaxis failure are unclear. In this study, we aimed to identify risk factors for inpatient VTE despite thromboprophylaxis. We conducted a case-control study to identify independent predictors for inpatient VTE. Among patients discharged from the BJC HealthCare system between January 2010 and May 2011, we matched 94 cases who developed in-hospital VTE while taking thromboprophylaxis to 272 controls who did not develop VTE. Matching was done by hospital, patient age, month and year of discharge. We used multivariate conditional logistic regression to develop a VTE prediction model. We identified five independent risk factors for in-hospital VTE despite thromboprophylaxis: hospitalization for cranial surgery, intensive care unit admission, admission leukocyte count >13,000/mm3, presence of an indwelling central venous catheter, and admission from a long-term care facility. We identified five risk factors associated with the development of VTE despite thromboprophylaxis in the hospital setting. By recognizing these high-risk patients, clinicians can prescribe aggressive VTE prophylaxis judiciously and remain vigilant for signs or symptoms of VTE.
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影响因子：
6.3
作者：
Leibson CL;Petterson TM;Smith CY;Bailey KR;Ashrani AA;Heit JA
通讯作者：
Heit JA
影响因子：
11.1
作者：
Schmidt M;Horvath-Puho E;Thomsen RW;Smeeth L;Sørensen HT
通讯作者：
Sørensen HT
影响因子：
4.8
作者：
Kleber, FX;Witt, C;Flosbach, CW
通讯作者：
Flosbach, CW
影响因子：
7.5
作者：
Connolly GC;Khorana AA;Kuderer NM;Culakova E;Francis CW;Lyman GH
通讯作者：
Lyman GH
影响因子：
158.5
作者：
Francis, Charles W.
通讯作者：
Francis, Charles W.