住院恶性肿瘤患者静脉血栓栓塞症风险及预防情况分析

doi:10.16689/j.cnki.cn11-9349/r.2020.03.008

Abstract
Figure/Table
References (0)
Related Citation (15)

Download: PDF (493 KB) HTML (1 KB)
Export: BibTeX | EndNote (RIS)

Abstract To evaluate venous thromboembolism risk in hospitalized cancer patients using the Khorana score, and compare thromboprophylaxis strategies of cancer patients at different risk levels of venous thromboembolism. Methods Cancer patients hospitalized in a tertiary hospital in Beijing during January 2017 and October 2019 were enrolled. Electronic medical records were reviewed to obtain patient characteristics, Khorana score, and thromboprophylaxis information. Results The median Khorana score of 1834 patients was 2(1, 2). 9.0%(165/1834),70.0%(1284/1834), and 21.0%(385/1834) of these patients were classified as low, intermediate and high-risk, respectively. 8.8% (83/941), 71.7% (675/941), and 19.4% (183/941) of surgical patients were in low, intermediate, and high-risk groups, respectively. While in patients only receiving chemotherapy, 6.5%(18/679),69.2%(193/279), and 24.4%(68/279) were at low, intermediate and high-risk of venous thromboembolism, respectively. The overall thromboprophylaxis rates in all patients, surgical patients, and patients only receiving chemotherapy were 61.7% (1131/1834), 83.3% (784/941), and 41.9% (117/279), respectively. The overall thromboprophylaxis rates differed significantly among different risk levels of Khorana score in all patients and surgical patients (P=0.002,P=0.016). There was no significant difference in thromboprophylaxis rate among different risk levels of Khorana score in patients receiving chemotherapy (P=0.060). However, in all patients and surgical patients, the distribution of three prophylaxis strategies (pure pharmacologic prophylaxis, pure mechanical prophylaxis, pharmacologic and mechanical prophylaxis) have no significant difference among three risk levels of Khorana Score (P=0.167, P=0.081). Conclusion Hospitalized cancer patients were at a relatively high risk of venous thromboembolism, but the prescription of thromboprophylaxis was not enough. Medical staff did not adjust prophylaxis strategies according to the risk level of venous thromboembolism. Hence, medical staff should evaluate venous thromboembolism risk of cancer patients, and adopt appropriate prophylaxis strategies to reduce the incidence of bleeding and venous thromboembolism.

	Service

	E-mail this article
	Add to my bookshelf
	Add to citation manager
	E-mail Alert
	RSS
	Articles by authors
	Qin Dan
	Jin Shuai
	Zhang Lichuan
	Han Shuying
	Shi Hanping
	Lu Qian

Cite this article:

Qin Dan,Jin Shuai,Zhang Lichuan, et al. The analysis of venous thromboembolism risk and thromboprophylaxis in hospitalized cancer patients[J]. Electron J Metab Nutr Cancer, 2020, 7(3): 289-294.

URL:

http://182.92.200.144/EN/10.16689/j.cnki.cn11-9349/r.2020.03.008 OR http://182.92.200.144/EN/Y2020/V7/I3/289

1.郑荣寿, 孙可欣, 张思维, 等, 2015年中国恶性肿瘤流行情况分析［J］. 中华肿瘤杂志, 2019, 41(1):19-28.
2.KHORANA A A, FRANCI C W, CULAKOVA E, et al. Thromboembolism is a leading cause of death in cancer patients receiving outpatient chemotherapy［J］. J Thromb Haemost, 2007, 5(3):632-634.
3.LLYMAN G H, ECKERT L, WANG Y, et al. Venous thromboembolism risk in patients with cancer receiving chemotherapy: a real-world analysis［J］. Oncologist, 2013, 18(12):1321-1329.
4.COHEN A T, KATHOLING A, RIETBROCK S, et al. Epidemiology of first and recurrent venous thromboembolism in patients with active cancer. A population-based cohort study［J］. Thromb Haemost, 2017, 117(1):57-65.
5.KHORANA A A, FRANCIS C W, CULAKOVA E, et al. Frequency, risk factors, and trends for venous thromboembolism among hospitalized cancer patients［J］. Cancer, 2007, 110(10):2339-2346.
6.LLOYD A J, DEWILDE S, NOBLE S, et al. What impact does venous thromboembolism and bleeding have on cancer patients quality of life?［J］. Value Health, 2018, 21(4):449-455.
7.AY C, PABINGER I, COHEN AT. Cancer-associated venous thromboembolism: Burden, mechanisms, and management［J］. Thromb Haemost, 2017, 117(2):219-230.
8.李廷廷, 战翠萍, 崔久嵬. 癌症相关性血栓形成的病理机制进展［J］. 中国实验诊断学, 2019, 23(5):932-935.
9.ADELBORG K, CORRAINI P, DARVALICS B, et al. Risk of thromboembolic and bleeding outcomes following hematological cancers: a danish population-based cohort study［J］. J Thromb Haemost, 2019, 17(8):1305-1318.
10.BLOM J W, DOGGEN C J M, OSANTO S, et al. Malignancies, prothrombotic mutations, and the risk of venous thrombosis［J］. JAMA, 2005, 293(6):715-722.
11.ANGELINI D E, RADIVOYEVITCH T, MCCRAE K R, et al. Bleeding incidence and risk factors among cancer patients treated with anticoagulation［J］. Am J Hematol, 2019, 94(7):780-785.
12.KHORANA A A, KUDERER N M, CULAKOVA E, et al. Development and validation of a predictive model for chemotherapy-associated thrombosis［J］. Blood, 2008, 111(10):4902-4907.
13.PATELL R, RYBICKI L, MCCRAE K R, et al. Predicting risk of venous thromboembolism in hospitalized cancer patients: utility of a risk assessment tool［J］. Am J Hematol, 2017, 92(6):501-507.
14.石汉平, 赵青川, 王昆华, 等. 营养不良的三级诊断［J］. 中国癌症防治杂志, 2015, 7(5):313-319.
15.PARKER A, PETERSON E, LEE A Y Y, et al. Risk stratification for the development of venous thromboembolism in hospitalized patients with cancer［J］. J Thromb Haemost, 2018, 16(7):1321-1326.
16.HIRAIDE M, SHIGA T, MINAWA Y, et al. Identification of risk factors for venous thromboembolism and evaluation of Khorana venous thromboembolism risk assessment in Japanese lung cancer patients［J］. J Cardiol, 2020, 75(1):110-114.
17.GIUSTOZZI M, CURCIO A, WEIJS B, et al. Variation in the association between antineoplastic therapies and venous thromboembolism in patients with active cancer［J］. Thromb Haemost, 2020, 120(5):847-856.
18.LI M, GUO Q, HU W. Incidence, risk factors, and outcomes of venous thromboembolism after oncologic surgery: a systematic review and meta-analysis［J］. Thromb Res, 2019, 173:48-56.
19.邝允勋, 李佳玉, 何海龙, 等. Caprini风险评估模型预测恶性肿瘤住院患者深静脉血栓形成的确证性研究［J］. 中国肿瘤临床, 2019, 46(13):682-685.
20.中国临床肿瘤学会肿瘤与血栓专家委员会. 肿瘤相关静脉血栓栓塞症预防与治疗指南(2019版)［J］. 中国肿瘤临床, 2019, 46(13):653-660.
21.吴倩, 王淑芳, 徐旭娟. 护士癌性静脉血栓栓塞护理预防知信行现状调查［J］. 护理研究, 2015, 29(33):4122-4126.
22.ZWICKER J I, ROJAN A, CAMPIGOTTO F, et al. Pattern of frequent but nontargeted pharmacologic thromboprophylaxis for hospitalized patients with cancer at academic medical centers: a prospective, cross-sectional, multicenter study［J］. J Clin Oncol, 2014, 32(17):1792-1796.
23.KEY N S, KHORANA A A, KUDERER N M, et al. Venous thromboembolism prophylaxis and treatment in patients with cancer: ASCO clinical practice guideline update［J］. J Clin Oncol, 2020, 38(5):496-520.
24.SAMAMA C M, BOUBLI L, COLOBY P, et al. Venous thromboembolism prophylaxis in patients undergoing abdominal or pelvic surgery for cancer-a real-world, prospective, observational French study: préobs［J］. Thromb Res, 2014, 133(6):985-992.
25.KAHN S R, MORRISON D R, DIENDERE G, et al. Interventions for implementation of thromboprophylaxis in hospitalized patients at risk for venous thromboembolism［J］. Cochrane Database Syst Rev, 2018, 4: CD008201.