Failure of chemical thromboprophylaxis in critically ill medical and surgical patients with sepsis

Autor: Jennifer M. Hanify, Lori Dupree, Donald Johnson, Jason Ferreira
Rok vydání: 2017
Předmět:
Male
medicine.medical_specialty
ARDS
medicine.drug_class
Critical Illness
Population
030204 cardiovascular system & hematology
Critical Care and Intensive Care Medicine
law.invention
Positive-Pressure Respiration
Sepsis
03 medical and health sciences
0302 clinical medicine
Risk Factors
law
Internal medicine
Odds Ratio
medicine
Humans
Treatment Failure
cardiovascular diseases
Enoxaparin
Risk factor
Intensive care medicine
education
Aged
Retrospective Studies
Respiratory Distress Syndrome
education.field_of_study
Heparin
business.industry
Incidence
Incidence (epidemiology)
Anticoagulant
Anticoagulants
Venous Thromboembolism
Odds ratio
Length of Stay
Middle Aged
equipment and supplies
medicine.disease
Intensive care unit
Hospitalization
Intensive Care Units
Logistic Models
030228 respiratory system
Female
business
Zdroj: Journal of Critical Care. 37:206-210
ISSN: 0883-9441
DOI: 10.1016/j.jcrc.2016.10.002
Popis: Critically ill patients who develop sepsis may be at a higher risk of venous thromboembolism (VTE) prophylaxis failure; however, studies in this population are limited. The objective of this study was to identify the incidence of VTE prophylaxis failure in this population.This retrospective review of patients admitted to the intensive care unit between February 2013 and September 2015 included patients who were diagnosed with sepsis and received heparin or enoxaparin VTE prophylaxis.Of the 355 patients included, 42 (12.5%) developed a VTE. Acute respiratory distress syndrome (ARDS) (31% vs 16.7%, P = .0272) and higher positive end expiratory pressure (10 vs 8, P = .0066) were associated with increased risk of VTE prophylaxis failure. Logistic regression identified ARDS an event risk factor (odds ratio, 2.58; 95% confidence interval, 1.22-5.42). The VTE was associated with an increased intensive care unit (14 vs 9 days, P = .01) and hospital length of stay (26 vs 15 days, P.0001). The median time from sepsis diagnosis to VTE event was 9 days (interquartile range, 5-13).Critically ill patients with sepsis had a high rate of VTE prophylaxis failure with ARDS being identified as a risk factor for VTE prophylaxis failure.
Databáze: OpenAIRE
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