危重症颅脑损伤患者住院期间发生静脉血栓栓塞症的危险因素

Risk factors for venous thromboembolism in critically ill patients with craniocerebral injury during hospitalization

目的探讨危重症颅脑损伤患者住院期间发生静脉血栓栓塞症(VTE)的危险因素。方法收集2021年4月至2023年3月南京医科大学第一附属医院(江苏省人民医院)收治的152例危重症颅脑损伤患者的临床资料,根据住院期间是否发生VTE将患者分为VTE组(n=30)和对照组(n=122)。收集并比较两组患者的基本信息、颅脑损伤相关专科信息以及术后住院期间的检查、检测结果,并采用多因素Logistic回归模型分析危重症颅脑损伤患者住院期间发生VTE的危险因素。结果VTE组患者的年龄、合并高血压比例、入院时C反应蛋白水平升高、合并下肢损伤的比例以及使用有创呼吸机的比例均高于对照组患者,差异均有统计学意义(P﹤0.05)。多因素分析结果显示,老年(年龄﹥60岁)、合并高血压、入院时C反应蛋白水平升高、合并下肢损伤及使用有创呼吸机均为危重症颅脑损伤患者住院期间发生VTE的独立危险因素(P﹤0.05)。结论老年、合并高血压、入院时C反应蛋白水平升高、合并下肢损伤及使用有创呼吸机均与危重症颅脑损伤患者住院期间发生VTE密切相关,临床中应注意对存在这些危险因素的患者加强监测和预防。

Objective To investigate the risk factors of venous thromboembolism(VTE)in critically ill patients with craniocerebral injury during hospitalization.Method The clinical data of 152 critically ill patients with traumatic brain injury admitted to the First Affiliated Hospital with Nanjing Medical University(Jiangsu Province Hospital)from April 2021 to March 2023 were collected.According to whether VTE occurred during hospitalization,there were 30 cases in the VTE group and 122 cases in the control group.The basic information of two groups of patients,specialized information on craniocerebral injury,as well as examination and testing results during postoperative hospitalization were collected and compared,and a multivariate Logistic regression model was used to analyze the factors related to the occurrence of VTE in critically ill craniocerebral injury patients during hospitalization.Result The age,proportion of patients with hypertension,elevated C-reactive protein levels at admission,proportion of patients with lower extremity injuries,and proportion of patients using invasive ventilators in the VTE group were all higher than those in the control group,and the differences were statistically significant(P<0.05).Multivariate analysis showed that elderly(age>60 years old),concomitant hypertension,elevated C-reactive protein at admission,concomitant lower extremity injury,and the use of invasive ventilators were all risk factors for VTE during hospitalization in critically ill patients with craniocerebral injury.Conclusion Elderly(age>60 years old),concomitant hypertension,elevated C-reactive protein at admission,concomitant lower extremity injury,and the use of invasive ventilator are closely related to the occurrence of VTE during hospitalization in critically ill patients with craniocerebral injury.In clinical practice,monitoring and prevention should be strengthened for patients with these risk factors.