Venous thromboembolism and the utility of the Padua Prediction Score in patients with sepsis admitted to internal medicine departments
Venous thromboembolism and the utility of the Padua Prediction Score in patients with sepsis admitted to internal medicine departments
复制标题
DOI：
10.1111/jth.12108
复制
发表时间：
2013-03-01
影响因子：
10.4
通讯作者：
Bitterman, H.
中科院分区：
文献类型：
--
作者：
Vardi, M.;Ghanem-Zoubi, N. O.;Bitterman, H.
背景脓毒症在内科（IM）部门很普遍。患有脓毒症和慢性疾病的老年患者发生静脉血栓栓塞症（VTE）的风险增加。本研究的目的是评估静脉血栓栓塞的发生率和帕多瓦预测评分（PPS）预测静脉血栓栓塞的准确性，脓毒症患者入住IM部门。方法我们前瞻性地收集了一个社区医疗中心的感染性疾病患者的资料。此外，我们回顾性收集了住院后1年内的VTE风险因素和事件。我们计算了每个患者的PPS，并相应地分析了数据。结果共纳入1080例患者。平均年龄为74.68 ± 16.1岁。平均PPS为4.86 +/- 2.26，71.2%的患者具有阳性PPS。仅17.8%的患者在住院期间接受抗凝预防。7例患者在入院时发生VTE，14例（1.29%）在医院内获得性VTE，7例（0.65%）在出院后发生VTE。住院期间死亡率为21.9%，总生存率为64%。PPS与抗凝治疗（P=0.36）、院内VTE（P=0.23）和1年VTE（P=0.40）均无相关性，但与院内死亡和生存率显著相关（P
Background Sepsis is prevalent in internal medicine (IM) departments. Elderly patients with sepsis and chronic medical conditions are at an increased risk for venous thromboemolism (VTE). The objective of this study was to assess the rate of VTE and the accuracy of the Padua Prediction Score (PPS) to predict VTE in patient with sepsis admitted to IM departments. Methods We prospectively collected data on septic patients admitted to IM departments in a community-based medical center. Additionally, we retrospectively collected VTE risk factors and events throughout a 1-year post hospitalization period. We computed the PPS for every patient, and analyzed the data accordingly. Results In total, 1080 patients were included in the study. The mean age was 74.68 +/- 16.1years. The average PPS was 4.86 +/- 2.26, and 71.2% of the patients had a positive PPS. Only 17.8% of the patients received anticoagulant prophylaxis during their hospital stay. Seven patients had VTE on admission, 14 (1.29%) acquired in-hospital VTE, and 7 (0.65%) had VTE post discharge throughout 1year. In all, 21.9% patients died during hospitalization, and the overall survival rate was 64%. PPS was not correlated with anticoagulant administration (P=0.36), in-hospital VTE (P=0.23) or 1-year VTE (P=0.40), but was significantly associated with in-hospital death and survival (P