{"title":"泰国重症内科病人深静脉血栓发生率低:一项前瞻性研究","authors":"","doi":"10.1016/j.rpth.2024.102522","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>Critically ill medical patients face a heightened risk of developing venous thromboembolism. In Thailand, routine thromboprophylaxis is not employed. The incidence of deep vein thrombosis (DVT) in the medical intensive care unit (ICU) has not been elucidated in the Thai population.</p></div><div><h3>Objectives</h3><p>The aims were to evaluate the incidence of DVT and identify associated risk factors in critically ill medical patients.</p></div><div><h3>Methods</h3><p>A single-center, prospective cohort study was conducted from 2019 to 2020. Consecutive patients underwent screening for proximal DVT by duplex ultrasound of both legs.</p></div><div><h3>Results</h3><p>A total of 200 patients were enrolled, with 115 being male (57%). The mean (SD) age was 66.5 (16.4) years. The mean (SD) Acute Physiology and Chronic Health Evaluation II score was 27 (8). The cumulative incidence of DVT over 5 days was 7% (95% CI, 3.4%-10.6%). No clinically or radiologically diagnosed pulmonary embolism occurred in patients with DVT. No independent risk factor associated with DVT was identified. Hospital mortality in those with and those without DVT was 42.9% and 32.3%, respectively. There was no significant difference in the length of ICU or hospital stay or inpatient mortality between those with and those without DVT.</p></div><div><h3>Conclusion</h3><p>Without thromboprophylaxis, the incidence of DVT in the Thai population remains low. A strategy of screening ultrasound 5 to 7 days after admission to the ICU may be a suitable alternative to anticoagulant prophylaxis in critically ill Thai patients without symptoms of venous thromboembolism.</p></div>","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":null,"pages":null},"PeriodicalIF":3.4000,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2475037924002176/pdfft?md5=0eac4a000758dbfdb28e137ec97b0bea&pid=1-s2.0-S2475037924002176-main.pdf","citationCount":"0","resultStr":"{\"title\":\"Low incidence of deep vein thrombosis in critically ill medical patients in Thais: a prospective study\",\"authors\":\"\",\"doi\":\"10.1016/j.rpth.2024.102522\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><p>Critically ill medical patients face a heightened risk of developing venous thromboembolism. In Thailand, routine thromboprophylaxis is not employed. The incidence of deep vein thrombosis (DVT) in the medical intensive care unit (ICU) has not been elucidated in the Thai population.</p></div><div><h3>Objectives</h3><p>The aims were to evaluate the incidence of DVT and identify associated risk factors in critically ill medical patients.</p></div><div><h3>Methods</h3><p>A single-center, prospective cohort study was conducted from 2019 to 2020. Consecutive patients underwent screening for proximal DVT by duplex ultrasound of both legs.</p></div><div><h3>Results</h3><p>A total of 200 patients were enrolled, with 115 being male (57%). The mean (SD) age was 66.5 (16.4) years. The mean (SD) Acute Physiology and Chronic Health Evaluation II score was 27 (8). The cumulative incidence of DVT over 5 days was 7% (95% CI, 3.4%-10.6%). No clinically or radiologically diagnosed pulmonary embolism occurred in patients with DVT. No independent risk factor associated with DVT was identified. Hospital mortality in those with and those without DVT was 42.9% and 32.3%, respectively. There was no significant difference in the length of ICU or hospital stay or inpatient mortality between those with and those without DVT.</p></div><div><h3>Conclusion</h3><p>Without thromboprophylaxis, the incidence of DVT in the Thai population remains low. A strategy of screening ultrasound 5 to 7 days after admission to the ICU may be a suitable alternative to anticoagulant prophylaxis in critically ill Thai patients without symptoms of venous thromboembolism.</p></div>\",\"PeriodicalId\":20893,\"journal\":{\"name\":\"Research and Practice in Thrombosis and Haemostasis\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":3.4000,\"publicationDate\":\"2024-07-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.sciencedirect.com/science/article/pii/S2475037924002176/pdfft?md5=0eac4a000758dbfdb28e137ec97b0bea&pid=1-s2.0-S2475037924002176-main.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Research and Practice in Thrombosis and Haemostasis\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2475037924002176\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"HEMATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Research and Practice in Thrombosis and Haemostasis","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2475037924002176","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"HEMATOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
背景重症内科病人罹患静脉血栓栓塞症的风险更高。在泰国,并没有采用常规的血栓预防措施。目的评估重症内科病人深静脉血栓的发生率,并确定相关风险因素。方法在2019年至2020年期间开展了一项单中心前瞻性队列研究。结果 共有200名患者入组,其中男性115人(57%)。平均(标清)年龄为 66.5(16.4)岁。急性生理学和慢性健康评估 II 评分的平均值(标准差)为 27(8)分。5天内深静脉血栓的累积发生率为7%(95% CI,3.4%-10.6%)。深静脉血栓患者中未出现经临床或放射学诊断的肺栓塞。没有发现与深静脉血栓相关的独立风险因素。深静脉血栓患者和非深静脉血栓患者的住院死亡率分别为 42.9% 和 32.3%。在重症监护室或住院时间或住院死亡率方面,深静脉血栓患者与非深静脉血栓患者没有明显差异。对于没有静脉血栓栓塞症状的泰国重症患者来说,在入住重症监护室后5到7天进行超声筛查可能是抗凝预防的一个合适替代方案。
Low incidence of deep vein thrombosis in critically ill medical patients in Thais: a prospective study
Background
Critically ill medical patients face a heightened risk of developing venous thromboembolism. In Thailand, routine thromboprophylaxis is not employed. The incidence of deep vein thrombosis (DVT) in the medical intensive care unit (ICU) has not been elucidated in the Thai population.
Objectives
The aims were to evaluate the incidence of DVT and identify associated risk factors in critically ill medical patients.
Methods
A single-center, prospective cohort study was conducted from 2019 to 2020. Consecutive patients underwent screening for proximal DVT by duplex ultrasound of both legs.
Results
A total of 200 patients were enrolled, with 115 being male (57%). The mean (SD) age was 66.5 (16.4) years. The mean (SD) Acute Physiology and Chronic Health Evaluation II score was 27 (8). The cumulative incidence of DVT over 5 days was 7% (95% CI, 3.4%-10.6%). No clinically or radiologically diagnosed pulmonary embolism occurred in patients with DVT. No independent risk factor associated with DVT was identified. Hospital mortality in those with and those without DVT was 42.9% and 32.3%, respectively. There was no significant difference in the length of ICU or hospital stay or inpatient mortality between those with and those without DVT.
Conclusion
Without thromboprophylaxis, the incidence of DVT in the Thai population remains low. A strategy of screening ultrasound 5 to 7 days after admission to the ICU may be a suitable alternative to anticoagulant prophylaxis in critically ill Thai patients without symptoms of venous thromboembolism.