Use and outcomes of anticoagulants for the treatment and prevention of thrombosis among hospitalized patients

摘要 在美国，每年有超过 2-300 万人接受抗凝药物治疗 和预防血栓栓塞性疾病。用于预防心房中风等适应症 颤动静脉血栓栓塞的急性治疗，抗凝药物可显着降低 与血栓栓塞相关的发病率和死亡率。然而，抗凝剂也与 出血的重大风险以及患者的费用和负担。该提案的总体目标是 更深入地了解不同临床情况下抗凝剂的最佳使用，最终目标 就是最大化他们的利益并最小化他们的风险。该提案的另一个总体目标是 让方博士能够在指导学员和教师的成功历史的基础上发展 研究和指导计划旨在培训初级研究人员为患者职业生涯做好准备 面向心血管结果的研究。 该提案的研究目标将解决药物预防策略的当代使用 为了预防关节置换手术后静脉血栓栓塞，描述围手术期的趋势 需要中断长期抗凝治疗以接受治疗的患者的管理和结果 择期手术，并检查抗凝治疗满意度、健康相关性之间的关系 服用口服抗凝剂的人的生活质量和药物依从性。这些目标将有助于告知 临床实践中合理使用抗凝药物。 作为一名医院临床医生研究员，方博士担任英国大学的研究主任 加利福尼亚州旧金山 (UCSF) 医院医学部。她的研究计划基于 UCSF 出色的临床、培训和研究环境。该提案的目的将支持她 努力培养心血管结果研究人员，并加强她的能力 研究平台必须支持受训者的研究。

ABSTRACT More than 2 – 3 million people are prescribed anticoagulants every year in the United States for the treatment and prevention of thromboembolic conditions. Used for indications ranging from stroke-prevention in atrial fibrillation to the acute treatment of venous thromboembolism, anticoagulants can significantly reduce the morbidity and mortality related to thromboembolism. However, anticoagulants are also associated with significant risks of bleeding, as well as costs and burden to patients. The overall objective of this proposal is to gain greater insight into the optimal use of anticoagulants in different clinical situations, with the ultimate goal being to maximize their benefits and minimize their risks. The other over-arching goal of the proposal is to allow Dr. Fang to build upon a successful history of mentoring trainees and faculty in order to develop a research and mentoring program geared towards training junior investigators preparing for careers in patient- oriented cardiovascular outcomes research. The research aims of this proposal will address the contemporary use of pharmacologic prevention strategies to prevent venous thromboembolism after joint replacement surgery, describe trends in the periprocedural management and outcomes of patients who need to interrupt chronic anticoagulant therapy in order to undergo elective surgery, and examine the association between anticoagulant treatment satisfaction, health-related quality-of-life, and medication adherence in people taking oral anticoagulants. These aims will help inform the appropriate use of anticoagulants in clinical practice. As a hospital-based clinician investigator, Dr. Fang serves as the Research Director for the University of California, San Francisco (UCSF) Division of Hospital Medicine. Her research program is based in the outstanding clinical, training, and research environment of UCSF. The aims of this proposal will support her efforts in developing cardiovascular outcomes researchers, as well as strengthen the capacity that her research platform has to support mentee research.