八年间美国急诊科深静脉血栓的流行病学。

IF 1.9 Q2 EMERGENCY MEDICINE Clinical and Experimental Emergency Medicine Pub Date : 2024-10-16 DOI:10.15441/ceem.24.299
Eric Moyer, Kyle Bernard, Michael Gottlieb
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引用次数: 0

摘要

导言:深静脉血栓(DVT)是全球发病率和死亡率的重要原因之一,也是医疗费用的重要组成部分。然而,随着管理策略的不断发展,急需有关 ED 环境中深静脉血栓形成的发病率、入院率和医疗管理的最新数据:这项横断面研究使用 Cosmos 数据库分析了 2016-2023 年间因深静脉血栓而到急诊室就诊的患者。纳入标准包括年龄≥18 岁、ICD-10 编码为急性四肢深静脉血栓的患者。结果包括发病率、入院率和抗凝剂处方。数据采用描述性统计方法进行分析,并对上肢和下肢深静脉血栓进行分组分析:在 190,144,463 次急诊就诊中,深静脉血栓形成占 368,044 例(0.2%)。在这些病例中,119,986 例(32.6%)入院治疗,入院率在研究期间保持稳定。阿哌沙班是处方最多的抗凝药(40.3%),其次是利伐沙班(28.3%)、依诺肝素(7.9%)、华法林(3.6%)和达比加群(0.3%)。阿哌沙班的使用率从2016年的12.4%增至2023年的56.2%。下肢深静脉血栓占88.5%,入院率为32.1%,而上肢深静脉血栓占11.7%,入院率为37.0%:本研究总结了美国急诊室在852年间的深静脉血栓病例和处理情况。研究结果强调了稳定的发病率、与历史数据相比降低的入院率以及门诊治疗中 DOACs(尤其是阿哌沙班)使用的显著转变。这些趋势强调了循证实践54和持续研究对优化深静脉血栓管理和改善患者预后的重要性。
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Epidemiology of Deep Venous Thrombosis Among United States Emergency Departments Over an Eight-Year Period.

Introduction: Deep vein thrombosis (DVT) is a significant cause of morbidity and mortality worldwide, accounting for substantial healthcare utilization. However, as management strategies have evolved, there is a critical need for current data on incidence, admission rates, and medical management of DVT in the ED setting.

Methods: This cross-sectional study analyzed ED presentations for DVT from 2016-2023 using the Cosmos database. Inclusion criteria comprised patients aged ≥18 years with an ICD-10 code for acute extremity DVT. Outcomes included incidence rates, admission rates, and anticoagulant prescriptions. Data were analyzed using descriptive statistics, and subgroup analyses were performed for upper and lower extremity DVTs.

Results: Out of 190,144,463 total ED encounters, DVT represented 368,044 cases (0.2%). Among these cases, 119,986 (32.6%) were admitted, with admission rates stable over the study period. Apixaban was the most prescribed anticoagulant (40.3%), followed by rivaroxaban (28.3%), enoxaparin (7.9%), warfarin (3.6%), and dabigatran (0.3%). Use of apixaban increased from 12.4% in 2016 to 56.2% in 2023. Lower extremity DVTs comprised 88.5% of cases, with a 32.1% admission rate, while upper extremity DVTs accounted for 11.7% of cases, with a 37.0% admission rate.

Conclusion: This study provides a summary of DVT presentations and management in United States EDs over an eight52 year period. The findings highlight stable incidence rates, reduced admission rates compared to historical data, and a significant shift towards the use of DOACs, particularly apixaban, for outpatient management. These trends underscore the importance of evidence-based practices 54 and ongoing research to optimize DVT management and improve patient outcomes.

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CiteScore
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10.50%
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