Venous thromboembolism epidemiology: Implications for prevention and management
Venous thromboembolism epidemiology: Implications for prevention and management
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DOI：
10.1055/s-2002-32312
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发表时间：
2002-06-01
影响因子：
5.7
通讯作者：
Heit, JA
中科院分区：
文献类型：
--
作者：
Heit, JA
静脉血栓栓塞是一个主要的健康问题，其发病率超过千分之一。美国每年有超过20万例新病例。其中，30%的患者在30天内死亡;五分之一的患者因肺栓塞而猝死。尽管预防措施有所改进，但自1980年以来，静脉血栓栓塞的发病率没有显著变化。静脉血栓栓塞的独立风险因素包括年龄增加、男性、手术、创伤、住院或疗养院禁闭、恶性肿瘤、神经系统疾病伴肢体轻瘫、中心静脉导管/经静脉起搏器、既往浅静脉血栓形成和静脉曲张;在女性中，风险因素包括妊娠、口服避孕药和激素替代治疗。大约30%的存活患者在10年内发生复发性静脉血栓栓塞。复发的独立预测因素包括年龄增长、肥胖、恶性肿瘤和肢体轻瘫。大约28%的患者在20年内发展为静脉瘀血综合征。为降低静脉血栓栓塞发生率，提高生存率，预防复发和并发症，具有这些特征的患者应接受适当的预防。
Venous thromboembolism is a major health problem, with an incidence that exceeds 1 per 1000. Over 200,000 new cases occur in the United States annually. Of these, 30% of patients die within 30 days; one-fifth suffer sudden death due to pulmonary embolism. Despite improved prophylaxis, the incidence of venous thromboembolism has not changed significantly since 1980. Independent risk factors for venous thromboembolism include increasing age, male gender, surgery, trauma, hospital or nursing home confinement, malignancy, neurologic disease with extremity paresis, central venous catheter/ transvenous pacemaker, prior superficial vein thrombosis, and varicose veins; among women, the risk factors include pregnancy, oral contraceptives, and hormone replacement therapy. About 30% of surviving patients develop recurrent venous thromboembolism within 10 years. Independent predictors for recurrence include increasing age, obesity, malignant neoplasm, and extremity paresis. About 28% of patients develop venous stasis syndrome within 20 years. To reduce venous thromboembolism incidence, improve survival, and prevent recurrence and complications, patients with these characteristics should receive appropriate prophylaxis.