A retrospective analysis of venous thromboembolism risk and prevention in critically ill patients
10.3760/cma.j.issn.1671-0282.2013.05.016
- VernacularTitle:重症患者静脉血栓栓塞风险和预防的回顾性分析
- Author:
Hui ZHANG
;
Yu MA
;
Yuming WEN
;
Li LU
- Publication Type:Journal Article
- Keywords:
Venous thromboembolism;
Deep venous thrombosis;
Pulmonary embolism;
Critically ill patient;
Anticoagulation
- From:
Chinese Journal of Emergency Medicine
2013;22(5):517-520
- CountryChina
- Language:Chinese
-
Abstract:
Objective To estimate the venous thromboembolism (VTE) risk and prevention in critically ill patients admitted to ICU and discuss the appropriate strategy for prevention.Methods A total of 276 critically ill patients staying longer than 48 hours in ICU were enrolled for a retrospective single-center study.VTE risk assessment,methods for mechanical and pharmacological prophylaxis and demographic data were recorded.Simplified Caprini scores for VTE risk were counted in the first day and 7th day after admission to ICU,and were compared among internal medicine,surgery and trauma subgroups.Relationship between VTE risk and the clinic index was analyzed by Pearson test and Spearman test with SPSS 17.0 software.The prophylaxis strategy applied to patients without low risk of VTE was explored.Results Simplified Caprini scores were (8.71 ± 4.90) and (9.24-± 5.30) on the first day and the 7th day after admission respectively.Simplified Caprini score was significantly related to APACHE Ⅱ score (r =0.397,P =0.027).Meanwhile,simplified Caprini score in surgical and traumatic patients was higher than that in medical ill patients (14.02 ±2.01),(14.5 ± 1.29) vs.(6.55 ±3.98),P ＜0.01.The total rate of early prophylaxis measures used with mechanical prevention (13.43％) and pharmacological prophylaxis (5.22％) was only 18.28％ within 48 hours after admissioin of patients with highest riskof VTE.Even on the 7th day after admission to ICU,the total rate of prophylaxis measure employed with mechanical prevention (11.92％) and pharmacological prophylaxis (11.56％) for VTE was 25.83％.Conclusions Critically ill patients in ICU were subjected to extremely high risk of VTE.The VTE risk related closely to the severity of critically illness existed throughout the whole period of the ICU stay.Constant assessment for VTE risk and bleeding risk should be made with frequent assessment for critically ill patients.
