VTE Risk Profiles and Prophylaxis in Medical and Surgical Inpatients: The Identification of Chinese Hospitalized Patients' Risk Profile for Venous Thromboembolism (DissolVE-2)-A Cross-sectional Study
Zhenguo Zhai, Quancheng Kan, Weimin Li, Xinyu Qin, Jieming Qu, Yuankai Shi, Ruihua Xu, Yuming Xu, Zhu Zhang, Chen Wang, DissolVE-2 investigators, Fuyi Zhu, Min Jiang, Yingmei Deng, Xueqii Li, Deqin Geng, Jieming Zhai, Caifang Wang, Junhui Zhang, Jie Cao, Shaoyong Chen, Gangzhi Li, Liming Wang, Yulin Zhang, Xiang Liu, Xiaoju Zhang, Xianguo Luo, Xia Li, Li Zhao, Nanwei Zu, Xiaofang Lu, Lan Yang, Nuofu Zhang, Wuyan Pang, Yingqun Ji, Yazhou Yao, Xuhui Sun, Wenda Xu, Jianqing Zhao, Huilin Leng, Zehong Yu, Guangzhi Kuang, Yijiang Huang, Lin Chen, Juhong Shi, Shijie Xin, Peng Xiao, Zhiming Du, Yan Wei, Yongchun Liu, Chunfang Zhang, Yvming Xu, Zhou Yang, Ruijuan Liu, Yiheng Liu, Yan Chen, Jin Qin, Side Liu, Hui Zhou, Zhuo Zhang, Liping Wei, Tao Ren, Baojun Wang, Hong Chen, Guozhang Mao, Yinghua Ying, Guoxian Ding, Danhua Dui, Taiping Du, Xichun Li, Jie Lu, Defu Zheng, Tao He, Zhenguo Zhai, Quancheng Kan, Weimin Li, Xinyu Qin, Jieming Qu, Yuankai Shi, Ruihua Xu, Yuming Xu, Zhu Zhang, Chen Wang, DissolVE-2 investigators, Fuyi Zhu, Min Jiang, Yingmei Deng, Xueqii Li, Deqin Geng, Jieming Zhai, Caifang Wang, Junhui Zhang, Jie Cao, Shaoyong Chen, Gangzhi Li, Liming Wang, Yulin Zhang, Xiang Liu, Xiaoju Zhang, Xianguo Luo, Xia Li, Li Zhao, Nanwei Zu, Xiaofang Lu, Lan Yang, Nuofu Zhang, Wuyan Pang, Yingqun Ji, Yazhou Yao, Xuhui Sun, Wenda Xu, Jianqing Zhao, Huilin Leng, Zehong Yu, Guangzhi Kuang, Yijiang Huang, Lin Chen, Juhong Shi, Shijie Xin, Peng Xiao, Zhiming Du, Yan Wei, Yongchun Liu, Chunfang Zhang, Yvming Xu, Zhou Yang, Ruijuan Liu, Yiheng Liu, Yan Chen, Jin Qin, Side Liu, Hui Zhou, Zhuo Zhang, Liping Wei, Tao Ren, Baojun Wang, Hong Chen, Guozhang Mao, Yinghua Ying, Guoxian Ding, Danhua Dui, Taiping Du, Xichun Li, Jie Lu, Defu Zheng, Tao He
Abstract
Background: Limited data exist on VTE risk and prophylaxis in Chinese inpatients. The Identification of Chinese Hospitalized Patients' Risk Profile for Venous Thromboembolism-2 (DissolVE-2), a nationwide, multicenter, cross-sectional study, was therefore designed to investigate prevalence of VTE risks and evaluate VTE prophylaxis implementation compliant with the latest prophylaxis guidelines (American College of Chest Physicians [CHEST], 9th edition).
Methods: Adults admitted (≥ 72 h) to 60 urban, tertiary Chinese hospitals due to acute medical conditions or surgery from March to September 2016 were assessed for VTE risk. Risk assessments were made by using the Padua Prediction Scoring or Caprini Risk Assessment model, risk factors, and prophylaxis based on the CHEST guidelines, 9th edition.
Results: A total of 13,609 patients (6,986 surgical and 6,623 medical) were analyzed. VTE risk in surgical inpatients was categorized as low (13.9%; 95% CI, 13.1-14.7), moderate (32.7%; 95% CI, 31.6-33.8), and high (53.4%; 95% CI, 52.2-54.6); risk in medical patients was categorized as low (63.4%; 95% CI, 62.2-64.6) and high (36.6%; 95% CI, 35.4-37.8). Major risk factors in surgical and medical patients were major open surgery (52.6%) and acute infection (42.2%), respectively. Overall rate of any prophylaxis and appropriate prophylactic method was 14.3% (19.0% vs 9.3%) and 10.3% (11.8% vs 6.0%) in surgical and medical patients.
Conclusions: A large proportion of hospitalized patients reported VTE risk and low rate of CHEST-recommended prophylaxis. The data highlight the insufficient management of VTE risk and show the great potential for improving physicians' awareness and current practices across China.
Trial registry: Chinese Clinical Trial Registry; No.: ChiCTR-OOC-16010187; URL: http://www.chictr.org.cn/showproj.aspx?proj=17077.
Keywords: China; VTE; prophylaxis; risk profile.
Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.
Source: PubMed