北京地区急诊患者静脉血栓栓塞风险评估  

Risk assessment of venous thromboembolism in emergency patients in Beijing,a multicenter,regional,and cross-sectional study

作　　者：许铭缨 米玉红[1] 顾伟 李新柱 王丹丹 刘志伟[5] 祁璇 李建国[7] Xu Mingying;Mi Yuhong;Gu Wei;Li Xinzhu;Wang Dandan;Liu Zhiwei;Qi Xuan;Li Jianguo(Emergency&Critical Care Center,Beijing Anzhen Hospital,Capital Medical University,Beijing 100029,China;Emergency Department,Chui Yang Liu Hospital Affillated to Tsinghua University,Beijing100021,China;Liang Xiang Hospital,Fang Shan District,Beijing,Beijing 102401,China;EmergencyDepartment,Beijing Tsinghua Changgung Hospital,Beijing 102218,China;Emergency Department,Beijing Jishuitan Hospital,Beijing 100035,China;Emergency Department,Beijing Chaoyang Hospital,Capital Medical University,Beijing 100020,China;Emergency Department,Beijing Tiantan Hospital,Capital Medical University,Beijing 100050,China)

机构地区：[1]首都医科大学附属北京安贞医院急诊危重症中心,北京100029 [2]北京市垂杨柳医院急诊科,北京100021 [3]北京市房山区良乡医院急诊科,北京102401 [4]清华大学附属北京长庚医院急诊科,北京102218 [5]北京积水潭医院急诊科,北京100035 [6]首都医科大学附属北京朝阳医院急诊科,北京100020 [7]首都医科大学附属北京天坛医院急诊科,北京100050

出　　处：《中华急诊医学杂志》2023年第6期802-805,共4页Chinese Journal of Emergency Medicine

基　　金：北京市朝阳区科委课题(CYSF2049)。

摘　　要：目的通过对滞留急诊科72 h以上的内科患者静脉血栓栓塞症(venous thromboembolism,VTE)的风险及抗凝治疗相关出血风险的评估,以提高急诊医生对该部分患者VTE危险因素的识别能力及安全预防意识。方法收集多中心、同一时段符合入组标准的急诊内科患者,通过Padua和Caprini评分评估患者的VTE风险,同时采用HAS-BLED评分评估同一组人群抗凝相关出血的风险。结果来自2021年1月15日至2021年3月15日7家医疗中心,共收集930名符合入选标准的急诊内科患者纳入分析。存在VTE的高风险人群的比例分别为50.22%(Padua评分),78.49%(Caprini评分);高出血风险比例为40.43%(HAS-BLED评分)。结论滞留急诊超过72 h的内科患者,半数以上面临着高VTE风险;相对而言,该组患者具有较低的抗凝相关出血风险。Objective To assess the risk of venous thromboembolism(VTE)and anticoagulationrelated bleeding of acute critical emergency patients staying in the emergency department at least 72 h,so as to improve the ability of emergency physicians to identify risk factors of VTE and their awareness of safety prevention in these patients.Methods Multicenter emergency internal medicine patients meeting the inclusion criteria at the same time were collected.Padua and Caprini scores were used to evaluate the risk of VTE and the HAS-BLED score was used to assess the risk of anticoagulation-related bleeding.Results A total of 930 emergency patients from 7 medical centers were enrolled in our study from January 15,2021 to March 15,2021.The proportion of high-risk population with VTE was 50.22%with Padua score and 78.49%with Caprini score,respectively.The proportion of high-risk bleeding(HASBLED score)was 40.43%.Conclusions More than half of the acute critical ill patients who stay in emergency department for more than 72 h are at high risk of VTE.This group of patients have a relatively low risk of anticoagulation-related bleeding.

关 键 词：静脉血栓栓塞症 Padua评分 Caprini评分 HAS-BLED评分 北京 急诊科 

分 类 号：R543.6[医药卫生—心血管疾病]