VTE Risk Profiles and Prophylaxis in Medical and Surgical Inpatients: The Identification of Chinese Hospitalized Patients’ Risk Profile for Venous Thromboembolism (DissolVE-2)—A Cross-sectional Study

Chest: The Journal of Circulation, Respiration and Related Systems

Xinyu Qin^4¹  Ruihua Xu^8²  Yuming Xu^9³  Zhu Zhang^1,10⁴  Quancheng Kan^2⁵  Zhenguo Zhai^1⁶  Weimin Li^3⁷  Fuyi Zhu⁸  Yuankai Shi^7⁹  Jieming Qu^5,6^1,10  Chen Wang^1,10,11^1,11 

[1] Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai, China^4;Department of Medical Oncology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, Beijing, China^7;Department of Medical Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong, China^8;Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Henan, China^9;Department of Pharmacy, The First Affiliated Hospital of Zhengzhou University, Henan, China^2;Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, National Clinical Research Center for Respiratory Diseases, No. 2 Yinghua Dongjie, Hepingli, Beijing, China^1;Department of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University, Sichuan, China^3;Department of Respiratory Medicine, Capital Medical University, Beijing, China^11;Department of Respiratory Medicine, Huadong Hospital affiliated to Fudan University, Shanghai, China^6;Department of Respiratory Medicine, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China^5;Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China^10

关键词: China;    prophylaxis;    risk profile;    VTE;    CCU;    coronary care unit;    CHEST;    American College of Chest Physicians;   

DOI  :  10.1016/j.chest.2018.09.020

学科分类：呼吸医学

来源: American College of Chest Physicians

【 摘 要 】

Background Limited data exist on VTE risk and prophylaxis in Chinese inpatients. The Identification of Chinese Hospitalized Patients' Risk Profile for Venous Thromboembolism-2 (DissolVE-2), a nationwide, multicenter, cross-sectional study, was therefore designed to investigate prevalence of VTE risks and evaluate VTE prophylaxis implementation compliant with the latest prophylaxis guidelines (American College of Chest Physicians [CHEST], 9th edition). Methods Adults admitted (≥ 72 h) to 60 urban, tertiary Chinese hospitals due to acute medical conditions or surgery from March to September 2016 were assessed for VTE risk. Risk assessments were made by using the Padua Prediction Scoring or Caprini Risk Assessment model, risk factors, and prophylaxis based on the CHEST guidelines, 9th edition. Results A total of 13,609 patients (6,986 surgical and 6,623 medical) were analyzed. VTE risk in surgical inpatients was categorized as low (13.9%; 95% CI, 13.1-14.7), moderate (32.7%; 95% CI, 31.6-33.8), and high (53.4%; 95% CI, 52.2-54.6); risk in medical patients was categorized as low (63.4%; 95% CI, 62.2-64.6) and high (36.6%; 95% CI, 35.4-37.8). Major risk factors in surgical and medical patients were major open surgery (52.6%) and acute infection (42.2%), respectively. Overall rate of any prophylaxis and appropriate prophylactic method was 14.3% (19.0% vs 9.3%) and 10.3% (11.8% vs 6.0%) in surgical and medical patients. Conclusions A large proportion of hospitalized patients reported VTE risk and low rate of CHEST-recommended prophylaxis. The data highlight the insufficient management of VTE risk and show the great potential for improving physicians' awareness and current practices across China. Trial Registry Chinese Clinical Trial Registry; No.: ChiCTR-OOC-16010187; URL: http://www.chictr.org.cn/showproj.aspx?proj=17077.

【 授权许可】

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