Venous thromboembolism in nursing home residents: role of selected risk factors.
Venous thromboembolism in nursing home residents: role of selected risk factors.
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DOI：
10.1111/j.1532-5415.2012.04100.x
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发表时间：
2012-09
影响因子：
6.3
通讯作者：
Heit JA
中科院分区：
文献类型：
--
作者：
Leibson CL;Petterson TM;Smith CY;Bailey KR;Ashrani AA;Heit JA
疗养院（NH）的居民赋予静脉血栓栓塞（VTE）的风险增加，然而，风险分层/预防指南目前依赖于非NH的数据。提供NH特定的估计值，以评估为一般人群确定的VTE风险因素是否适用于NH居民。以人群为基础的病例对照研究：1988-2000年，明尼苏达州奥姆斯特德县所有有症状的客观诊断的VTE事件的县居民，同时是NH居民（N=182）;每个病例有两名年龄-性别-年龄-年龄匹配的非VTE奥姆斯特德县NH居民（N=364），审查与提供者相关的医疗记录，以获得活动性恶性肿瘤的信息;最近住院、手术或创伤/骨折（病例的VTE日期;对照的相应日期）。估计了所有奥姆斯特德县居民1988-2000年的风险因素患病率和静脉血栓栓塞相关比值比（OR），并与之前获得的数据进行比较。对于分析，两组均限于年龄≥65岁。在NH居民中，活动性恶性肿瘤、近期住院和近期手术显著增加了VTE风险，但风险程度似乎远低于一般人群估计值-例如，NH居民大手术的OR（95% CI）为2.5（1.4-4.3），而一般人群为11（7.0-17）。一般而言，NH对照组中所有评价的VTE风险因素的患病率均高于一般人群对照组。与一般人群相比，NH病例/对照组的血栓预防率似乎更高;令人不安的是，47%的NH病例接受了预防。虽然一般人群VTE风险因素（活动性癌症和近期住院或手术）可以识别出VTE风险增加的NH居民，但这些暴露并不能充分分层血栓预防建议的VTE风险。需要进一步研究NH特异性风险因素和预防有效性。
Nursing home (NH) residency confers increased venous thromboembolism (VTE) risk; however, risk-stratification/prevention guidelines currently rely on non-NH data. Provide NH-specific estimates to assess whether VTE risk factors identified for the general population apply to NH residents. Population-based case-control study Olmsted County, MN All County residents with symptomatic objectively-diagnosed incident VTE while a NH resident 1988–2000 (N=182); two age- sex- calendar-year-matched non-VTE Olmsted County NH residents per case (N=364) Provider-linked medical records were reviewed to obtain information on active malignancy; recent hospitalization, surgery, or trauma/fracture as of index (case’s VTE date; respective date for controls). Risk factor prevalence and VTE-associated odds ratios (OR) were estimated and compared with previously obtained data for all Olmsted County residents 1988–2000. For analyses, both groups were limited to age ≥65 years. Among NH residents, active malignancy, recent hospitalization and recent surgery conferred significantly increased VTE risk, but the magnitude of risk appeared much lower than general population estimates-- e.g., OR (95% CI) for major surgery was 2.5 (1.4–4.3) for NH residents versus 11 (7.0–17) for general population. In general, the prevalence of all evaluated VTE risk factors appeared much higher among NH controls compared to general population controls. Thromboprophylaxis rates appeared higher for NH cases/controls compared to the general population; disconcertingly, 47% of NH cases received prophylaxis. While general population VTE risk factors (active cancer and recent hospitalization or surgery) can identify NH residents at increased risk for VTE, these exposures do not adequately stratify VTE risk for thromboprophylaxis recommendations. Further research into NH-specific risk factors and prophylaxis effectiveness is required.
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影响因子：
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作者：
Heit, JA;Silverstein, MD;Melton, LJ
通讯作者：
Melton, LJ
DOI：
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影响因子：
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作者：
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通讯作者：
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