Title
Author
DOI
Article Type
Special Issue
Volume
Issue
Padua prediction score-guided use of low-molecular-weight heparin calcium treatment for the prevention of venous thromboembolism in elderly patients with intracerebral hemorrhage: a clinical observation
1Department of Rehabilitation Medicine, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, 310006 Hangzhou, Zhejiang, China
2Department of Intensive Care Unit, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, 310006 Hangzhou, Zhejiang, China
3Department of Medical Imaging, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, 310006 Hangzhou, Zhejiang, China
DOI: 10.22514/sv.2023.091 Vol.19,Issue 5,September 2023 pp.244-249
Submitted: 26 May 2023 Accepted: 03 July 2023
Published: 08 September 2023
*Corresponding Author(s): Fulian Zhang E-mail: chkeyan@zju.edu.cn
This study used the Padua Prediction Score (PPS) to guide low-molecular-weight heparin calcium (LMWHC) treatment for the prevention of venous thromboembolism (VTE) in elderly patients with intracerebral hemorrhage (ICH). This study retrospectively analyzed 225 elderly patients who were admitted to the intensive care unit (ICU) between June 2016 and June 2022. Patients were divided into control (n = 124) and study (n = 101) groups. Control patients received routine prevention and treatment of VTE, while patients in the study group received PPS-guided LMWHC treatment for the prevention of VTE. Multiple analytical parameters were assessed including thromboelastography indices, coagulation function parameters, venous blood flow velocity, and the incidence of VTE and recurrent ICH. Thromboelastography indices, coagulation function parameters, and the venous blood flow velocity did not differ significantly between the control and study groups (p > 0.05) before intervention and treatment. However, following PPS-guided LMWHC treatment, a significant improvement in these parameters was observed in the study group compared to the control group (p < 0.05). Furthermore, the incidence of VTE was significantly lower in the study group (5.6%) than the control group (14.5%; p = 0.038). No significance differences in the incidence of recurrent ICH were observed (p > 0.05). Our PPS data indicate that LMWHC treatment could significantly improve the coagulation function of elderly patients with ICH, as well as increase the venous blood flow velocity and prevent the occurrence of VTE.
Padua prediction score; Low-molecular-weight heparin calcium; Intracerebral hemorrhage; Venous thromboembolism; Elderly patients
Jinfeng Zhang,Longhuan Zeng,Li Sheng,Fulian Zhang. Padua prediction score-guided use of low-molecular-weight heparin calcium treatment for the prevention of venous thromboembolism in elderly patients with intracerebral hemorrhage: a clinical observation. Signa Vitae. 2023. 19(5);244-249.
[1] Forman R, Slota K, Ahmad F, Garg R, John S, Da Silva I, et al. Intracerebral hemorrhage outcomes in the very elderly. Journal of Stroke and Cerebrovascular Diseases. 2020; 29: 104695.
[2] Melmed KR, Boehme A, Ironside N, Murthy S, Park S, Agarwal S, et al. Respiratory and blood stream infections are associated with subsequent venous thromboembolism after primary intracerebral hemorrhage. Neurocritical Care. 2021; 34: 85–91.
[3] Fritz MK, Kincaid SE, Sargent CG, Green AH, Davis GA. Venous thromboembolism (VTE) risk stratification in general medical patients at an academic medical center. Journal of Thrombosis and Thrombolysis. 2021; 51: 67–73.
[4] Genuardi MV, Rathore A, Ogilvie RP, DeSensi RS, Borker PV, Magnani JW, et al. Incidence of VTE in patients with OSA. Chest. 2022; 161: 1073–1082.
[5] Bauersachs RM, Herold J. Oral anticoagulation in the elderly and frail. Hamostaseologie. 2020; 40: 74–83.
[6] Zhang X, Cai Q, Wang X, Liao K, Hu C, Chen H. Current use of rivaroxaban in elderly patients with venous thromboembolism (VTE). Journal of Thrombosis and Thrombolysis. 2021; 52: 863–871.
[7] Beauchamp-Chalifour P, Belzile ÉL, Michael R, Langevin V, Gaudreau N, Normandeau N, et al. The risk of venous thromboembolism in surgically treated hip fracture: a retrospective cohort study of 5184 patients. Orthopaedics & Traumatology: Surgery & Research. 2022; 108: 103142.
[8] Kozek-Langenecker S, Fenger-Eriksen C, Thienpont E, Barauskas G. European guidelines on perioperative venous thromboembolism prophylaxis. European Journal of Anaesthesiology. 2018; 35: 116–122.
[9] Ding D, Sekar P, Moomaw CJ, Comeau ME, James ML, Testai F, et al. Venous thromboembolism in patients with spontaneous intracerebral hemorrhage: a multicenter study. Neurosurgery. 2019; 84: E304–E310.
[10] Pandor A, Tonkins M, Goodacre S, Sworn K, Clowes M, Griffin XL, et al. Risk assessment models for venous thromboembolism in hospitalised adult patients: a systematic review. BMJ Open. 2021; 11: e045672.
[11] Lavon O, Tamir T. Evaluation of the Padua prediction score ability to predict venous thromboembolism in Israeli non-surgical hospitalized patients using electronic medical records. Scientific Reports. 2022; 12: 6121.
[12] Bates SM, Greer IA, Middeldorp S, Veenstra DL, Prabulos A, Vandvik PO. VTE, thrombophilia, antithrombotic therapy, and pregnancy. Chest. 2012; 141: e691S–e736S.
[13] Stevens SM, Woller SC, Kreuziger LB, Bounameaux H, Doerschug K, Geersing G, et al. Antithrombotic therapy for VTE disease. Chest. 2021; 160: e545–e608.
[14] Dun X, Wu Q, Ma Y, Hu W, Zuo X. Predicting venous thromboembolism in non-surgical hospitalized patients with type 2 diabetes mellitus: development and validation of a nomogram. American Journal of Translational Research. 2023; 15: 1281–1290.
[15] Kuderer NM, Poniewierski MS, Culakova E, Lyman GH, Khorana AA, Pabinger I, et al. Predictors of venous thromboembolism and early mortality in lung cancer: results from a global prospective study (CANTARISK). The Oncologist. 2018; 23: 247–255.
[16] Gran OV, Brækkan SK, Paulsen B, Skille H, Rosendaal FR, Hansen JB. Occult cancer‐related first venous thromboembolism is associated with an increased risk of recurrent venous thromboembolism. Journal of Thrombosis and Haemostasis. 2017; 15: 1361–1367.
[17] Timp JF, Braekkan SK, Lijfering WM, van Hylckama Vlieg A, Hansen JB, Rosendaal FR, et al. Prediction of recurrent venous thrombosis in all patients with a first venous thrombotic event: the Leiden thrombosis recurrence risk prediction model (L-TRRiP). PLOS Medicine. 2019; 16: e1002883.
[18] Yamashita Y, Morimoto T, Kadota K, Takase T, Hiramori S, Kim K, et al. Clinical characteristics, management strategies and outcomes of patients with recurrent venous thromboembolism in the real world. Scientific Reports. 2022; 12: 22437.
[19] Yogendrakumar V, Lun R, Khan F, Salottolo K, Lacut K, Graham C, et al. Venous thromboembolism prevention in intracerebral hemorrhage: a systematic review and network meta-analysis. PLOS ONE. 2020; 15: e0234957.
[20] Fan D, Ouyang Z, Ying Y, Huang S, Tao P, Pan X, et al. Thromboelas-tography for the prevention of perioperative venous thromboembolism in orthopedics. Clinical and Applied Thrombosis/Hemostasis. 2022; 28: 107602962210779.
[21] Razouki ZA, Ali NT, Nguyen VQ, Escalante CP. Risk factors associated with venous thromboembolism in breast cancer: a narrative review. Supportive Care in Cancer. 2022; 30: 8589–8597.
[22] Redi U, Marruzzo G, Codolini L, Chistolini A, Tarallo M, Marcasciano M, et al. Venous thromboembolism prophylaxis in plastic surgery: state of the art and our approach. European Review for Medical and Pharmacological Sciences. 2021; 25: 6603–6612.
[23] Venous thromboembolism in over 16s: reducing the risk of hospital-acquired deep vein thrombosis or pulmonary embolism. National Institute for Health and Care Excellence (NICE): London. 2019.
[24] Benes J, Skulec R, Jobanek J, Cerny V. Fixed-dose enoxaparin provides efficient DVT prophylaxis in mixed ICU patients despite low anti-Xa levels: a prospective observational cohort study. Biomedical Papers. 2022; 166: 204–210.
[25] Spyropoulos AC, Anderson FA, FitzGerald G, Decousus H, Pini M, Chong BH, et al. Predictive and associative models to identify hospitalized medical patients at risk for VTE. Chest. 2011; 140: 706–714.
Science Citation Index Expanded (SCIE) (On Hold)
Chemical Abstracts Service Source Index
Scopus: CiteScore 1.3 (2024)
Embase
Top