Use of Intermittent Pneumatic Compression and Not Graduated Compression Stockings Is Associated With Lower Incident VTE in Critically Ill Patients
| Autor: | Gousia S. Dhar, Shaila Bhat, Yaseen M. Arabi, Mohammad K. Khedr, Hani Tamim, Lara Afesh, Saqib I. Dara |
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| Rok vydání: | 2013 |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty business.industry medicine.medical_treatment Hazard ratio Intermittent pneumatic compression Retrospective cohort study Compression stockings equipment and supplies Critical Care and Intensive Care Medicine medicine.disease Pulmonary embolism Internal medicine Propensity score matching medicine cardiovascular diseases Cardiology and Cardiovascular Medicine Intensive care medicine Prospective cohort study business Cohort study |
| Zdroj: | Chest. 144:152-159 |
| ISSN: | 0012-3692 |
| Popis: | Background A limited amount of data exist regarding the effect of intermittent pneumatic compression (IPC) and graduated compression stockings (GCS) on the incidence of VTE in the ICU setting. The objective of this study was to examine the association of mechanical thromboprophylaxis with IPC or GCS with the risk of VTE and hospital mortality among critically ill medical-surgical patients. Methods In this prospective cohort study of patients admitted to the ICU of a tertiary-care medical center between July 2006 and January 2008, we used multiple propensity scores adjustment to examine the association of IPC and GCS with VTE. The primary outcome was incident VTE, including DVT and pulmonary embolism. The following data were collected: patient demographics, admission physiologic data, VTE risk factors, pharmacologic thromboprophylaxis, and mechanical thromboprophylaxis. Results Among 798 patients enrolled in the study, incident VTE occurred in 57 (7.1%). The use of IPC was associated with a significantly lower VTE incidence compared with no mechanical thromboprophylaxis (propensity scores adjusted hazard ratio, 0.45; 95% CI, 0.22-0.95; P = .04). GCS were not associated with decreased VTE incidence. No significant interaction was found between the mechanical thromboprophylaxis group and the type of prophylactic heparin used (P = .99), recent trauma (P = .66), or recent surgery (P = .07) on VTE risk. Conclusions The use of IPC, but not GCS, was associated with a significantly lower VTE risk. This association was consistent regardless of the type of prophylactic heparin used and was not modified by trauma or surgical admission. |
| Databáze: | OpenAIRE |
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