上海市多中心社区医院门诊患者深静脉血栓风险因素分析及认知水平评估

Risk factors and awareness of deep vein thrombosis among outpatients in Shanghai community hospitals:a multi-center study

目的探讨上海市多中心社区医院门诊患者深静脉血栓(DVT)的风险因素及认知水平。方法采用随机抽样的方法,按地区分布随机抽取上海市10家社区医院门诊患者710例。采用AutarDVT形成风险评估表和静脉血栓栓塞症(VTE)自我管理能力相关知识测试量表进行问卷调查,分析社区医院门诊患者DVT风险程度和VTE自我管理能力评分的影响因素。结果DVT中高危患者年龄≥65岁、文化程度小学及以下、慢性病、体质量指数(BMI)≥28kg/m^(2)、郊区比例高于DVT低危患者(88.0%vs50.9%,65.5%vs26.5%,94.8%vs86.2%,12.9%vs 5.2%,58.2%vs43.9%,P<0.01)。多因素logistic回归分析显示,年龄、文化程度、慢性病、多病共存、BMI、地区是影响社区门诊患者DVT风险程度的独立危险因素(P<0.05,P<0.01);高血压、脑梗死、脑出血、恶性肿瘤是影响多病共存患者DVT风险程度的独立危险病种(P<0.01)。患者的年龄、文化程度、慢性病、BMI、吸烟、地区因素与其VTE自我管理能力评分有关(P<0.05,P<0.01)。结论全科医师应高度关注存在老年、肥胖、文化程度较低、慢性病、多病共存及郊区等情况的社区门诊患者,尤其是老年多病共存患者,同时提高居民对DVT危害性的认识和自我管理能力。

Objective To explore the risk factors and awareness level of deep vein thrombosis(DVT)in elderly outpatients in Shanghai community hospitals.Methods A total of 710 elderly outpatients were subjected with random sampling from 10 community hospitals in Shanghai.Au-tar deep vein thrombosis risk assessment scaee and venous thromboembolism(VTE)selEmanage-ment ability related knowledge scale were used to conduct questionnaire investigation.The influ-encing factors for risk level of DVT and for VTE seE-management ability score were analyzed in these patients.Results The high-risk DVT group had significantly larger proportions of aged 65 years,primary school education or below,chronic diseases,BML>28 kg/m^(2),and suburban re.ri-dents than the low-risk DVT patients(88.0%vs 50.9%,65.5%vs 26.5%,94.8%vs 86.2%,12.9%vs 5.2%,58.2%vs 43.9%,P<0.01).Multivariate logistic regression analysis showed that age,education level,chronic disease,multimorbidity,BM1 and residential area were independent risk factors for risk level of DVT in the elderly outpatients in community hospitals(P<0.05,P<0.01).Hypertension,cerebral infarction,cerebral hemorrhage and malignant tumors were inde-pendent risk diseases of DVT in the patients with multimorbidity(P<0.01).Age,education level,chronic diseases,BM1,smoking,residential area and other factors were related to the score of VTE self-management(P<0.05,P<0.01).Conclusion General practitioners should pay close attention to the elderly outpatients in community hospitals,with characteristics ol advanced age,obesity,lower education level,chronic disease,multimorbidity and living in suburban area,espe-cially those with multiple diseases.What’s more,awareness ol risk lor DVT and self-management ability should be improved simultaneously.