Incidence of deep vein thrombosis and quality of venous thromboembolism prophylaxis

OBJECTIVE: to determine the incidence of deep vein thrombosis and prophylaxis quality in hospitalized patients undergoing vascular and orthopedic surgical procedures. METHODS: we evaluated 296 patients, whose incidence of deep venous thrombosis was studied by vascular ultrasonography. Risk factors for venous thrombosis were stratified according the Caprini model. To assess the quality of prophylaxis we compared the adopted measures with the prophylaxis guidelines of the American College of Chest Physicians. RESULTS: the overall incidence of deep venous thrombosis was 7.5%. As for the risk groups, 10.8% were considered low risk, 14.9%moderate risk, 24.3% high risk and 50.5% very high risk. Prophylaxis of deep venous thrombosis was correct in 57.7%. In groups of high and very high risk, adequate prophylaxis rates were 72.2% and 71.6%, respectively. Excessive use of chemoprophylaxis was seen in 68.7% and 61.4% in the low and moderate-risk groups, respectively. CONCLUSION: although most patients are deemed to be at high and very high risk for deep vein thrombosis, deficiency in the application of prophylaxis persists in medical practice.

【研究目的】明确接受血管外科与骨科手术的住院患者深静脉血栓（Deep Vein Thrombosis）的发病率，以及血栓预防措施的实施质量。
【研究方法】本研究共纳入296例患者，通过血管超声检查评估其深静脉血栓发病率；采用卡普里尼（Caprini）血栓风险模型对静脉血栓栓塞的危险因素进行分层。同时参照美国胸科医师学会（American College of Chest Physicians, ACCP）制定的血栓预防指南，对比实际采用的预防措施与指南要求，以评估预防质量。
【研究结果】本研究中深静脉血栓总体发病率为7.5%。按风险分层统计，低风险组占比10.8%，中风险组14.9%，高风险组24.3%，极高风险组50.5%。深静脉血栓预防措施的整体达标率为57.7%；其中高风险组与极高风险组的预防达标率分别为72.2%与71.6%。而低风险组与中风险组中，分别有68.7%与61.4%的患者存在药物化学预防过度使用的情况。
【研究结论】尽管多数患者被判定为深静脉血栓高风险及极高风险人群，但临床实践中血栓预防措施的应用仍存在明显不足。