Analysis Of Risk Factors And Prophylaxis In Hospitalized Patients With Venous Thromboembolism

Object We retrospectively analyzed the risk factors of venous thromboembolism in patients who had recent hospitalized history and prophylaxis during hospitalization to further explore the risk factors of venous thromboembolism in hospitalized patients and the reasonable and prophylaxis status of venous thromboembolism during hospitalization.Methods 108 patients with venous thromboembolism who had hospitalized history within 6 weeks from January 2016 to January 2017 in our hospital were enrolled,and 200 controls without venous thromboembolism were selected remedied at the same hospital.All subjects in this case-control study were collected the data of age,sex,height,weight,blood type,history of recent surgery,bedridden history of previous disease,leukocyte,neutrophil,lymphocyte,neutrophil / lymphocyte ratio,fibrinogen,total Cholesterol,triglycerides,high-density lipoprotein,low density lipoprotein,blood uric acid.The case group was scored according to the Caprini thrombosis risk assessment model,VTE prophylaxis which had been taken and the last hosptial level wa recorded.We aimed to explore the association of the above factors and venous thromboembolism through the single factor and multivariate analysis and analysis the prophylaxis status of venous thromboembolism during hospitalization.Results(1)By univariate analysis and multivariate analysis,age(OR=1.572,95%CI1.079~2.241,P<0.05)),blood type(OR=3.621,95 %CI1.532~5.67795,P<0.05),recent surgery(OR=4.324,95%CI1.401~4.376,P < 0.05),malignancy(OR=3.563,95 %CI 1.433~5.576,P < 0.05),neutrophil / lymphocyte ratio(OR=2.325,95 %CI 1.316~4.110,P < 0.05),D-dimer(OR=3.944,95 %CI 2.420~6.428,P<0.05)and serum uric acid(OR=3.462,95 %CI 1.464~8.376,P<0.05)were associated with venous thromboembolism.(2)According to Caprini score of case groups,46 patients were in low risk group,103 patients in intermediate risk group and 31 patients in high risk group.(3)In the case group,39 cases were from tertiary hospitals,of which 11 cases did not receive prophylaxis,28 cases received prophylaxis,and 10 cases received adequate prophylaxis;.72 cases were from secondary hospitals,of which 51 did not received prophylaxis,21 cases received prophylaxis,and 3 cases received adequate prophylaxis;69 cases were from primary hospitals,of which 68 cases did not receive prophylaxis and 1 case received prophylaxis.Conclusions(1)This study show that recent surgery,blood group,malignancy,neutrophil / lymphocyte ratio,D-dimer,serum uric acid may be independent risk factors of VTE in hospitalized patients.(2)The proportion of VTE prophylaxis in hospitalized patients with moderate and high risk VTE was low,and the proportion of sufficient prophylaxis was lower than the former.(3)The lower the hospital grade,the lower the proportion of hospitalized patients receiving VTE prophylaxis.(4)We should fully assess the risk of hospitalized patients with VTE and adopt reasonable and effective VTE prophylaxis individualized to reduce the incidence of VTE in hospitalized patients.