Incidence of venous thromboembolism and adequacy of thromboprophylaxis in 2380 acutely-ill hospitalized patients: Results from the PROFMiG cohort study

IF 3.7 3区 医学 Q1 HEMATOLOGY Thrombosis research Pub Date : 2024-09-05 DOI:10.1016/j.thromres.2024.109145
Bruno Ávila Ferreira , Pedro Luiz Lage Bodour Danielian , Geovanna Cota Caetano , Cássia Rodrigues Lima Ferreira , Maria Aparecida de Oliveira , Enrico Antônio Colosimo , Marcos de Bastos , Suely Meireles Rezende
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Abstract

Introduction

Hospital-acquired venous thromboembolism (VTE) is a major cause of preventable deaths. Incidence of VTE and adequacy of thromboprophylaxis have rarely been reported in low-resourced countries. The aim of this study was to estimate the incidence of VTE and to evaluate the adequacy of thromboprophylaxis in acutely-ill medical hospitalized patients.

Methods

The PROFMiG is a prospective cohort study conducted in Brazil. We consecutively enrolled adult (> 18 years) acutely-ill hospitalized medical patients at admission. Risk assessment for VTE was evaluated by the IMPROVE7 (International Medical Prevention Registry on Venous Thromboembolism). Outcomes were death and VTE events during hospital stay up to 90 days after discharge. All VTE and death events were adjudicated. We also evaluated pulmonary embolism-related death and adequacy of thromboprophylaxis. VTE incidence was estimated by competing risk methods.

Results

A total of 2380 participants was included. Median age was 70 years, 56.1 % women, median length of hospital stay was 10 days. A total of 2052 (86.3 %) patients were classified as low-risk for VTE, 30 (1.3 %) patients had objectively confirmed VTE, and 1449 (60.8 %) received inadequate thromboprophylaxis. The overall mortality rate was 14.0 %. Cumulative incidence of VTE was 2.0 % (95 % confidence interval 0.9 %–3.8 %) at 130 days after admission when considering death as competing risk.

Conclusion

The cumulative incidence of VTE in this cohort corroborates with that reported in high-resourced countries. Despite recommendation, thromboprophylaxis was mostly inadequate. We suggest the adoption of competing risk analysis to estimate the cumulative incidence of VTE in hospitalized patients.

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2380 名急性病住院患者的静脉血栓栓塞发病率和血栓预防措施的充分性:PROFMiG 队列研究的结果
导言医院获得性静脉血栓栓塞症(VTE)是可预防死亡的主要原因。在资源匮乏的国家,VTE的发病率和血栓预防措施的充分性鲜有报道。本研究的目的是估计 VTE 的发病率,并评估急性内科住院病人血栓预防措施的充分性。方法 PROFMiG 是一项在巴西开展的前瞻性队列研究。我们连续招募了入院时患有急性病的成年(18 岁)内科住院患者。VTE风险评估由IMPROVE7(静脉血栓栓塞国际医疗预防登记)进行评估。结果为住院期间至出院后 90 天内的死亡和 VTE 事件。所有 VTE 和死亡事件均已判定。我们还评估了肺栓塞相关死亡和血栓预防的充分性。VTE 发生率采用竞争风险法进行估算。中位年龄为 70 岁,56.1% 为女性,中位住院时间为 10 天。共有 2052 名患者(86.3%)被归类为 VTE 低风险患者,30 名患者(1.3%)被客观证实为 VTE 患者,1449 名患者(60.8%)接受了不适当的血栓预防措施。总死亡率为 14.0%。如果将死亡视为竞争风险,入院 130 天后 VTE 的累积发生率为 2.0%(95% 置信区间为 0.9%-3.8%)。尽管有建议,但血栓预防措施大多不足。我们建议采用竞争风险分析法来估算住院患者的 VTE 累积发病率。
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来源期刊
Thrombosis research
Thrombosis research 医学-外周血管病
CiteScore
14.60
自引率
4.00%
发文量
364
审稿时长
31 days
期刊介绍: Thrombosis Research is an international journal dedicated to the swift dissemination of new information on thrombosis, hemostasis, and vascular biology, aimed at advancing both science and clinical care. The journal publishes peer-reviewed original research, reviews, editorials, opinions, and critiques, covering both basic and clinical studies. Priority is given to research that promises novel approaches in the diagnosis, therapy, prognosis, and prevention of thrombotic and hemorrhagic diseases.
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