大学教学医院内科病房住院患者静脉血栓栓塞风险、预防及转归

F. Ahmed, S. Hussen, T. Assefa
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引用次数: 6

摘要

背景:在静脉血栓栓塞(VTE)患者中,深静脉血栓形成和肺栓塞是住院患者致残和死亡的重要原因。本研究旨在评估提库尔安贝萨专科医院(TASH)病房住院患者静脉静脉血栓栓塞的风险、预防和预后。材料和方法:采用TASH静脉血栓栓塞预防和治疗指南中的仪器,对200例TASH住院患者的病历进行回顾性横断面研究。数据通过EPI Info 7录入,导出到SPSS 21版软件数据库进行分析。结果:在200例住院患者中,186例(93%)至少存在两种静脉血栓形成的危险因素。只有75例(40%)患者接受了血栓预防,61例(32.8%)患者接受了血栓预防。然而,高风险和高危人群中有11人(5.5%)在住院期间发生静脉血栓栓塞。在128/200(64%)的研究参与者中,由于这些信息没有记录在专利图表上,因此不知道静脉血栓栓塞结局的状况。在与VTE发生相关的14个变量中,多变量logistic回归分析显示,年龄≥60岁,AOR=6.55 (95% CI [1.40 ~ 30.74]), AMI, AOR=83.22 (95% CI[3.07 ~ 225.90]),肺部疾病(包括肺炎),AOR=9.55 (95% CI[11.62 ~ 56.40]),最近一个月内卒中,AOR=1.61 (95% CI[9.16 ~ 16.8])是VTE事件发生的独立预测因素。结论:在本研究中,所有患者至少有一个静脉血栓栓塞的危险因素。只有37.5%的患者接受TP治疗。有必要实施TASH提出的现有循证指南。
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Venous Thromboembolism Risk, Prophylaxis and Outcome in Hospitalized Patients to Medical Wards of University Teaching Hospital
Background: In patients with venous thromboembolism (VTE), deep vein thrombosis and pulmonary embolism are important causes of disability and death in hospitalized patient. This study aimed at assessing venous VTE risks and prophylaxis and outcome in hospitalized patients to medical wards of Tikur Anbessa Specialized Hospital (TASH). Material and methods: A retrospective cross sectional study involving 200 patients' chart review in those who admitted to medical wards of TASH was conducted using the instrument from TASH guideline on VTE prophylaxis and treatment. Data was entered by EPI Info 7 and then exported to SPSS 21 version software database for analysis. Results: Out of 200 medically admitted patients, 186 (93%) of them had at least two risk factors for VTE development. Only 75 (40%) patients received thromboprophylaxis and VTE was prevented in 61 (32.8%) patients who received prophylaxis. However, 11 (5.5%) of high and highest risk categories study population, developed VTE during their stay at hospital. In 128/200 (64%) study participants, the status of VTE outcome was not known since such information was not documented on patents’ charts. Among 14 variables associated with occurrence of VTE, multivariable logistic regression analysis revealed that patients aged ≥ 60 years, AOR=6.55 (95% CI [1.40-30.74]), AMI, AOR=83.22 (95% CI [3.07-225.90]), lung diseases including pneumonia, AOR=9.55 (95% CI [11.62-56.40]) and having stroke within one last month, AOR=1.61 (95% CI [9.16-16.8]) were independent predictors for development of VTE events. Conclusion: In this study, all patients have at least one risk factor for VTE. Only 37.5% of patients received TP. There is a need for implementation of existing evidence based guidelines proposed by TASH.
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