在院发生静脉血栓栓塞症的影响因素分析  

Analysis of influential factors of venous thromboembolism during hospitalization

作　　者：高稚[1] 梁志刚[1] 孟岩[1] Gao Zhi;Liang Zhigang;Meng Yan(Department of Information Center,Xuanwu Hospital,Capital Medical University,Beijing 100053,China)

机构地区：[1]首都医科大学宣武医院信息中心,北京100053

出　　处：《北京医学》2023年第4期299-303,共5页Beijing Medical Journal

摘　　要：目的探讨在院发生静脉血栓栓塞症(venous thromboembolism,VTE)的影响因素。方法选取2020年1月至2021年12月首都医科大学宣武医院手术患者,根据是否发生VTE分为VTE组和非VTE组。采用倾向性得分1∶2的比例进行匹配,采用多因素logistic回归方程分析VTE的影响因素。结果共纳入患者42903例,其中男19674例,女23229例,年龄18~99岁,平均(55.8±15.3)岁,BMI平均(24.92±3.76)kg/㎡,发生VTE 177例,VTE发生率为0.41%,经倾向性得分成功匹配177对。多因素logistic回归分析显示,神经外科(OR=2.165,95%CI:1.103~4.246,P=0.025)、骨科(OR=2.503,95%CI:1.151~5.445,P=0.021)、住院≥7 d(OR=10.808,95%CI:4.893~23.870,P=0.000)、在院发生感染(OR=23.293,95%CI:5.108~106.230,P=0.000),入院Barthel指数评分中轻度依赖(OR=1.895,95%CI:1.049~3.421,P=0.034)、中度依赖(OR=2.576,95%CI:1.086~6.109,P=0.032)和重度依赖(OR=13.542,95%CI:4.907~37.371,P=0.000)的手术患者在院发生VTE的风险更大。结论VTE发生科室、住院天数、在院发生感染、入院Barthel指数评分均会影响手术患者在院发生VTE,医疗机构应做好患者风险评估,并有针对性的进行防控,以降低VTE发生。Objective To explore the influencing factors of venous thromboembolism(VTE)occurred during hospitalization.Methods Patients who had surgery in Xuanwu Hospital,Capital Medical University from January 2020 to December 2021 were selected,and were divided into VTE group and non-VTE group according to whether VTE occurred or not.The ratio of propensity score 1:2 was used for matching,and multivariate logistic regression equation analysis was used to analyze the influencing factors of VTE.Results A total of 42903 patients were included,including 19674 males and 23229 females,aged 18-99 years,with an average age of(55.8±15.3)years,an average BMI of(24.92±3.76)kg/㎡.VTE occurred in 177 cases,the incidence rate of VTE was 0.41%.And 177 pairs were successfully matched by the propensity score matching.Multivariate logistic regression analysis showed that neurosurgery(OR=2.165,95%CI:1.103-4.246,P=0.025),orthopedics(OR=2.503,95%CI:1.151-5.445,P=0.021),hospitalization greater than 7 days(OR=10.808,95%CI:4.893-23.870,P=0.000),nosocomial infection(OR=23.293,95%CI:5.108-106.230,P=0.000),results of Barthel index score of admission such as mild dependence(OR=1.895,95%CI:1.049-3.421,P=0.034),moderate dependence(OR=2.576,95%CI:1.086-6.109,P=0.032),and heavy dependence(OR=13.542,95%CI:4.907-37.371,P=0.000)patients were at higher risk of VTE in hospital.Conclusions The department where VTE occurs,the number of days of hospitalization,the infection in the hospital,and the Barthel index score of admission will all affect the occurrence of VTE in the hospital,and medical institutions should do a good job in patient risk assessment,and carry out corresponding measures to prevent and control the occurrence of VTE.

关 键 词：静脉血栓栓塞症 下肢深静脉血栓形成 肺动脉栓塞症 手术 在院 影响因素 

分 类 号：R654.3[医药卫生—外科学]