• Title/Summary/Keyword: Venous Thromboembolism

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Correlation of the Incidence rate of Venous Thromboembolism with Prophylaxis Method in the Intensive care unit of Cancer Patients for Intermittent Air Pressure Medical Device Research (Venous Thromboembolism in Intensive care unit of Cancer patients) (간헐적공기압박 의료기기연구를 위한 중환자실에서 치료중인 암환자들의 정맥혈전색전증 발생률과 예방법에 따른 상관관계 연구)

  • Kang, Hyun Guy;Chung, Seung Hyun;Kim, Hyun Boem;Kim, Kwang Gi
    • Journal of Biomedical Engineering Research
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    • v.39 no.1
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    • pp.36-42
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    • 2018
  • The risk of venous thromboembolism (VTE) is known higher in cancer patients and lower incidence in the east country. This study was conducted in order to check the incidence rate of VTE in the Korean high risk patients who are treated in the intensive care unit (ICU), and to verify the correlation of the incidence of VTE and prophylaxis methods. This study was conducted as a retrospective study for 492 cancer patients from April 2011 to December 2014. According to the medical records of subjects, their prophylaxis methods and the incidence of VTE were surveyed and then correlation of them was investigated with statistical methods. 385 patients met the inclusion criteria. VTE occrred in 17 of them (4.4%). The prophylaxis methods are consisted of medical method (136 subjects), mechnical method(33 subjects), and medical & mechnkcal method (124 subjects). VTE occurred in 14 patients (4.8%) from 293 patients (76%) who were given at least one prophylaxis method. From all of 93 patients without prophylaxis, three patients experienced VTE (3.3%). The target patients were high risk in VTE, but the incidence rate of VTE was lower than reported in previous studies. The reason of this is considered that more active prophylaxis intervention was applied to the subjects because of their high risk status. As a result, it is considered that in the high risk patients, it would be effective to apply active and complex prophylaxis intervention for the prevention of VTE.

Anticoagulation after pancreatic surgery with venous resection (TIGRESS): What should we do? Results from an international survey

  • Thomas B. Russell;Debora Ciprani;Somaiah Aroori
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.27 no.4
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    • pp.423-426
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    • 2023
  • Backgrounds/Aims: Patients who undergo pancreatic surgery with venous resection have high rates of morbidity/mortality. Also, they are high-risk for postoperative venous thromboembolism. Whether this group should be routinely anticoagulated is unknown. This study aimed to establish current anticoagulation practices. Methods: A survey (https://form.jotform.com/220242489107048) was sent out to pancreatic surgeons. Questions covered center volume, venous resection/reconstruction techniques and anticoagulation policies. Results: Sixty-five centers from 17 countries responded. Following a "side-bite" venous resection with a patch repair, 40% used an autologous vein patch, 27% used peritoneum, and 27% used a bovine patch. After formally resecting a segment of vein, 17% of centers used an interposition graft (IG). Left renal vein (41%) and polytetrafluoroethylene (73%) grafts were the most commonly used autologous and prosthetic IGs, respectively. Following a prosthetic IG, an autologous IG, and a "side-bite" resection, 59%, 28%, and 19% of centers provided therapeutic anticoagulation, respectively (66% used low molecular-weight heparin). The duration of therapy provided varied from inpatient stay only (14%) to six months (32%). Conclusions: Our global survey indicates that anticoagulation practices are highly variable. Centers do not agree on when to anticoagulate, how to anticoagulate, or the duration of therapy. A robust trial is required to provide clarity.

Respiratory Review of 2013: Pulmonary Thromboembolism

  • Hwang, Hun Gyu;Schulman, Sam
    • Tuberculosis and Respiratory Diseases
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    • v.75 no.3
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    • pp.89-94
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    • 2013
  • Pulmonary embolism (PE), which can originate as a consequence of deep vein thrombosis (DVT), is the most frequent and potentially fatal venous thromboembolic event. Despite the fact that the incidence of venous thromboembolism (VTE) in Asians is lower than that in the Western populations, a recent epidemiologic study demonstrates an increasing incidence of VTE in the Korean population. Anticoagulants, including low molecular weight heparin (LMWH) and vitamin K antagonist (VKAs), have been the main treatments for PE, however, recently new oral anticoagulants (NOACs) were introduced. We will review how well patients with PE can be managed with the existing anticoagulants and NOACs along with the time span of treatment, which still pose some challenges for clinicians.

Knowledge, Health Belief, and Preventive Behavioral Intention related to Venous Thromboembolism (VTE) of the Patients with Lower Limb Musculoskeletal System Disorders (근골격계 하지손상환자의 정맥혈전색전증 관련 지식과 건강신념 및 예방행동의도)

  • Yang, Hye Jin;Kang, Hee-Young
    • The Journal of Korean Academic Society of Nursing Education
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    • v.19 no.4
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    • pp.531-541
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    • 2013
  • Purpose: This study was done to examine the relationship among knowledge, health belief, and preventitive behavioral intention related to venous thromboembolism (VTE) in patients with lower-limb musculoskeletal disorders. Methods: This transversal descriptive study looked at 145 adult patients with lower-limb musculoskeletal disorders, who were hospitalized in C hospital in G city. Data were collected from September 29 to October 6, 2012. Knowledge, health belief and preventitive behavioral intention were measured by structured questionnaires. Date were analyzed by descriptive statistics, one-way ANOVA, independent t-test, and Pearson correlation, using the SPSS program. Results: The mean score of knowledge related to VTE was low. The mean scores of health belief and preventitive behavioral intention related to VTE were moderate or higher than average. Preventitive behavioral intention positively correlated with knowledge, perceived benefit, and health motivation. Whereas, there was a negative correlation between preventitive behavioral intention and perceived barriers. Conclusion: These results suggest that developing a health care program which is able to enhance knowledge, perceived benefit, and health motivation related to VTE and reduce perceived barriers, is essential in order to promote preventitive behaviors.

New Anticoagulants for the Prevention and Treatment of Venous Thromboembolism

  • Kim, Joo Hee;Lim, Kyung-Min;Gwak, Hye Sun
    • Biomolecules & Therapeutics
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    • v.25 no.5
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    • pp.461-470
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    • 2017
  • Anticoagulant drugs, like vitamin K antagonists and heparin, have been the mainstay for the treatment and prevention of venous thromboembolic disease for many years. Although effective if appropriately used, traditional anticoagulants have several limitations such as unpredictable pharmacologic and pharmacokinetic responses and various adverse effects including serious bleeding complications. New oral anticoagulants have recently emerged as an alternative because of their rapid onset/offset of action, predictable linear dose-response relationships and fewer drug interactions. However, they are still associated with problems such as bleeding, lack of reversal agents and standard laboratory monitoring. In an attempt to overcome these drawbacks, key steps of the hemostatic pathway are investigated as targets for anticoagulation. Here we reviewed the traditional and new anticoagulants with respect to their targets in the coagulation cascade, along with their therapeutic advantages and disadvantages. In addition, investigational anticoagulant drugs currently in the development stages were introduced.

Venous Thromboembolism Following Acute Ischemic Stroke: A Prospective Incidence Study

  • Ko, Keun Hyuk;Kang, Ji-Hoon;Kang, Sa-Yoon;Lee, Jung Seok;Song, Sook-Keun;Oh, Jung-Hwan;Kim, Joong-Goo;Han, Eun Young;Lee, Ho Kyu;Choi, Jay Chol
    • Journal of Neurocritical Care
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    • v.11 no.2
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    • pp.102-109
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    • 2018
  • Background: A sians were known to have a relatively lower incidence of venous thromboembolism (VTE), and there is insufficient evidence to suggest a specific D-dimer threshold level for screening VTE in patients with acute stroke. Methods: We prospectively enrolled patients with acute ischemic stroke admitted to Jeju National University Hospital. The inclusion criteria were: 1) aged ${\geq}18$ years, 2) admission within seven days of symptom onset, and 3) an initial National Institute of Health Stroke Scale (NIHSS) score >1 for the affected lower limb. Ultrasound scans of the lower limbs and plasma D-dimer assays were performed on days 7-14 and 15-28 after stroke onset. Results: Of 285 patients admitted during the study period, 52 patients met inclusion criteria (mean age 74.5, male 40.4%, median initial NIHSS score 12, and unable to walk unassisted at discharge 76.9%). During 7-14 days, 23 of 52 patients (44.2%) had a D-dimer level above 1.57 mg/L, and 9.6% had a level above 5.50 mg/L. Proximal deep vein thrombosis (DVT) was detected in 3 patients (5.8%, 95% confidence Interval 1.2-16.0%) on ultrasound examination. All DVTs were found in elderly female patients with severe leg weakness. No patient was diagnosed with pulmonary embolism during the study period. Conclusion: The incidence of VTE seems to be very low among Korean patients with acute ischemic stroke. Advanced age, female sex, and severe leg weakness were important risk factors for developing DVT in this study.

Comparative Study of Compliance for Venous Thromboembolism Prophylaxis (American College of Chest Physicians Guideline and American College of Orthopedic Surgeons Guideline) in High Risk Patients with a Venous Thromboembolism (정맥혈전 색전증 고위험군에서 시행한 혈전색전 예방요법(American College of Chest Physicians 지침 및 American College of Orthopedic Surgeons 지침)의 준수율 비교 연구)

  • Suh, You-Sung;Nho, Jae-Hwi;Jang, Byung-Woong;Kang, Deokwon;Won, Sung-Hun
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.4
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    • pp.317-326
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    • 2019
  • Purpose: To compare and analyze the rate of prevention of two venous thromboembolism prophylaxis guidelines in patients with artificial joint arthroplasty and hip joint fracture. Proper prophylaxis for preventing thromboembolism in orthopedic surgery is significant because of this fetal complication. Materials and Methods: This study compared and retrospective analyzed the rate of prevention using the medical records and radiographs of patients who underwent orthopedic surgery from March 2009 to February 2011 according to the American College of Chest Physicians (ACCP) guidelines and from March 2012 to February 2014 according to the American Academy of Orthopedic Surgeons (AAOS) guidelines. Results: The guidelines for venous thromboembolism prophylaxis have been applied to patients with artificial joint replacement and hip joint fracture, the compliance rate of the ACCP guidelines was 56.0% before surgery, 67.0% after surgery with chemical prophylaxis, and 80.5% with mechanical prophylaxis. In addition, the compliance rate of the AAOS guidelines was 74.1% with chemical prophylaxis, and 88.3% with mechanical prophylaxis, which was higher than the ACCP guidelines. The compliance rates of mechanical and chemical prophylaxis before and after surgery of the ACCP guidelines, and the compliance rate of mechanical and chemical prophylaxis of the AAOS guidelines were compared and analyzed. The results revealed statistical significance (p<0.05) before and after total knee replacement arthroplasty and hip joint fracture internal fixation and total high risk orthopedic surgery. Conclusion: Raising the compliance rate of prophylaxis of venous thromboembolism in high risk orthopedic surgery is necessary and people should follow the guidelines for a unified direction depending on which situation they are in.