Brit J Heamatol:静脉血栓栓塞门诊患者维生素K拮抗剂治疗期间大出血的预测

2020-05-02 MedSci原创 MedSci原创

该研究所开发的风险评分可以识别出门诊病人中有明显出血风险的病人,特别是有大出血风险病人。

出血是与抗凝治疗相关的最常见并发症,但其特征尚未完全明确,且对风险/获益评估很重要。近日,血液系统疾病权威杂志British Journal of Haematology上发表了一篇研究文章,研究人员使用英国临床实践研究数据链开发了风险分层评分,以预测静脉血栓栓塞(VTE)患者维生素K拮抗剂(VKA)治疗相关的出血。

门诊患者大出血事件包括在开始服用VKA90天内出现大出血和需要住院的临床相关非大出血(CRNMB-H)。研究人员通过亚风险比制定了一种预测出血的评分方案,并使用交叉验证进行了验证,且由C统计量进行表示。

该研究队列由接受VKA治疗的10010例首次VTE患者组成,平均年龄为62.2岁。在2008年至2016年之间,该研究共记录了167起大出血事件(1.7%),即发生率为7.4/100人每年。社区获得性大出血的独立预测因素包括活动性癌症、创伤/外科手术、男性、痴呆、肝病、贫血、出血史、脑血管、肾脏和慢性肺部疾病、VTE表现为肺栓塞和年龄超过75岁。对于大出血总体C统计量为0.68(95%CI为0.60-0.76)和0.75(0.60-0.88),对于 CRNMB‐H为0.65(0.55-0.75),并且比研究人群应用的其他风险评分要高。

由此可见,该研究所开发的风险评分可以识别出门诊病人中有明显出血风险的病人,特别是有大出血风险病人。

原始出处:

Carlos Martinez.et al.Prediction of significant bleeding during vitamin K antagonist treatment for venous thromboembolism in outpatients.british journal of haematology.2020.https://onlinelibrary.wiley.com/doi/10.1111/bjh.16383

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    2020-10-01 fusion
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    2020-07-16 xue8602
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    2020-05-04 cmsvly
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