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Zeng Q, Lu G, Yuan J, Ding J, Chen J, Gao X, Huang Y, Shi T, Yu H, Ni H, Li Y. Prevalence, characteristics, and risk factors of venous thromboembolism in patients with brain tumor undergoing craniotomy: a meta-analysis. Neurol Sci 2024; 45:1565-1580. [PMID: 37947983 DOI: 10.1007/s10072-023-07160-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 10/22/2023] [Indexed: 11/12/2023]
Abstract
BACKGROUND Brain tumor patients undergoing craniotomy are significantly associated with the development of venous thromboembolism (VTE), while the contributing factors remains controversial. Our study aimed to investigate the prevalence and risk factors for VTE in postoperational brain tumor patients. METHODS We searched the PubMed, Embase, Web of Science, Medline, and Cochrane Library databases from their inception to July 2023. Article selection, data extraction, and study quality assessment were performed independently by two reviewers. Publication bias was assessed using Egger's and Begg's tests. Stata 15.0 software was used for data analysis. RESULTS A total of 25 studies were considered, with a total of 49,620 brain tumor individuals. The pooled prevalence of VTE during hospitalization in postoperational brain tumor patients was 9% [95% CI: (0.08, 0.10)]. Moreover, our results demonstrated that patients with VTE were older than those without VTE [mean difference [MD] = 8.14, 95% CI: (4.97, 11.30)]. The following variables were significantly associated with VTE: prior history of VTE [OR = 7.81, 95% CI: (3.62, 16.88)], congestive heart failure [OR = 2.33, 95% CI: (1.08-5.05)], diabetes [OR = 1.87, 95% CI: (1.12-3.10)], hypertension [OR = 1.27, 95% CI: (1.07-1.50)], steroid use [OR = 1.63, 95% CI: (1.41, 1.88)], high white blood cells counts [MD = 0.32, 95% CI: (0.01, 0.63)], and high fibrinogen levels [MD = 0.19, 95% CI: (0.08, 0.30)]. CONCLUSION This meta-analysis identified risk factors for postoperational VTE in patients with brain tumor, which can serve as a theoretical foundation for medical staff to manage and treat VTE. TRIAL REGISTRATION CRD42023357459.
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Affiliation(s)
- Qingping Zeng
- School of Nursing, Medical College of Yangzhou University, Yangzhou University, Yangzhou, China
- Department of Neuro Intensive Care Unit, Clinical Medical College of Yangzhou University, Yangzhou, China
| | - Guangyu Lu
- School of Public Health, Medical College of Yangzhou University, Yangzhou University, Yangzhou, China
| | - Jing Yuan
- Department of Echocardiography, Northern Jiangsu People's Hospital, Yangzhou, China
| | - Jiali Ding
- School of Nursing, Medical College of Yangzhou University, Yangzhou University, Yangzhou, China
- Department of Neuro Intensive Care Unit, Clinical Medical College of Yangzhou University, Yangzhou, China
| | - Juan Chen
- School of Nursing, Medical College of Yangzhou University, Yangzhou University, Yangzhou, China
- Department of Neuro Intensive Care Unit, Clinical Medical College of Yangzhou University, Yangzhou, China
| | - Xianru Gao
- School of Nursing, Medical College of Yangzhou University, Yangzhou University, Yangzhou, China
- Department of Neuro Intensive Care Unit, Clinical Medical College of Yangzhou University, Yangzhou, China
| | - Yujia Huang
- Department of Neuro Intensive Care Unit, Clinical Medical College of Yangzhou University, Yangzhou, China
- Neuro-Intensive Care Unit, Department of Neurosurgery, Clinical Medical College, Yangzhou University, Yangzhou, 225001, Jiangsu, China
| | - Tian Shi
- Department of Neuro Intensive Care Unit, Clinical Medical College of Yangzhou University, Yangzhou, China
- Neuro-Intensive Care Unit, Department of Neurosurgery, Clinical Medical College, Yangzhou University, Yangzhou, 225001, Jiangsu, China
| | - Hailong Yu
- Department of Neuro Intensive Care Unit, Clinical Medical College of Yangzhou University, Yangzhou, China
- Department of Neurology, Northern Jiangsu People's Hospital, Yangzhou, China
| | - Hongbin Ni
- Department of Neurosurgery, Nanjing Drum Tower Hospital, School of Medicine, Clinical College of Nanjing Medical University, Nanjing, 210008, Jiangsu, China.
| | - Yuping Li
- Department of Neuro Intensive Care Unit, Clinical Medical College of Yangzhou University, Yangzhou, China.
- Neuro-Intensive Care Unit, Department of Neurosurgery, Clinical Medical College, Yangzhou University, Yangzhou, 225001, Jiangsu, China.
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S. Aleidan F, Albilal S, Alammari M, Al Sulaiman K, Alassiri M, Abdel Gadir A. Does carbapenem-resistant enterobacteriaceae infection drive venous thromboembolism in patients admitted to intensive care units receiving prophylactic anticoagulants? JOURNAL OF APPLIED HEMATOLOGY 2022. [DOI: 10.4103/joah.joah_151_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Wu J, Zhu S, Munn Z, Zhou C. Improving compliance of risk assessment and nonpharmacological interventions for deep venous thrombosis prevention in a respiratory ICU: a best practice implementation project. JBI Evid Implement 2020; 19:268-278. [PMID: 33703871 DOI: 10.1097/xeb.0000000000000260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To increase the compliance with deep venous thrombosis (DVT) nonpharmacologic prophylaxis best practice recommendations while ensuring appropriate and structured nonpharmacologic prophylaxis for patients in the respiratory ICU. BACKGROUND DVT is a major problem for patients, with those who are critically ill representing a high-risk population for developing the condition. Nonpharmacologic prophylaxis is considered an effective intervention. However, the application of such interventions in practice has not been optimal to date. METHODS The current project was conducted in a respiratory ICU of a tertiary hospital. Audit criteria were developed on the basis of an evidence summary developed by the Joanna Briggs Institute, whereby the institute's Practical Application of Clinical Evidence System program to facilitate an audit and feedback cycle was utilized as an implementation framework. Baseline and follow-up audits on nonpharmacological DVT prophylaxis were conducted for 35 patients against five evidence-based recommendations. In addition, the nurses' knowledge and attitude regarding DVT prophylaxis were investigated both prior to and postimplementation. RESULTS In the baseline audit, compliance with the five evidence-based audit criteria was less than 15%. After the implementation of strategies including education, person-centered care, financial and human-resource support, there was a significant improvement in all the audit criteria. In addition, improvements in the nurses' knowledge and attitude regarding DVT prophylaxis were reported. The rate of discharged patients due to a deterioration of their condition decreased from 31.4 to 5.7% in the follow-up cycle. One DVT patient occurred in the baseline data, whereas no new incidences of DVT were found in the follow-up data. CONCLUSION The project not only improved nurses' knowledge and attitude regarding DVT prevention, but also remarkably improved the implementation of nonpharmacological DVT prophylaxis. The application of evidence-based nonpharmacological DVT prophylaxis may improve patients' outcomes in the ICU.
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Affiliation(s)
- Jinyan Wu
- Huiqiao Medical Center, Nanfang Hospital, Southern Medical University.,Nanfang Nursing Centre for Evidence-Based Practice: A JBI Centre of Excellence
| | - Shunfang Zhu
- Respiratory Department, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Zachary Munn
- Transfer Science Department, Faculty of Health and Medical Sciences, Joanna Briggs Institute, University of Adelaide, Adelaide, South Australia, Australia
| | - Chunlan Zhou
- Nursing Department, Nanfang Hospital, Southern Medical University, Guangzhou, China
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Hawkins A, Mazzeffi M, Abraham P, Paciullo C. Prevalence and factors associated with the absence of pharmacologic venous thromboembolism prophylaxis: A cross-sectional study of Georgia intensive care units. J Crit Care 2016; 36:49-53. [PMID: 27546747 DOI: 10.1016/j.jcrc.2016.06.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2016] [Revised: 05/16/2016] [Accepted: 06/10/2016] [Indexed: 12/31/2022]
Abstract
PURPOSE The need for venous thromboembolism prophylaxis is well accepted in the intensive care unit (ICU) and supported by a variety of guideline recommendations. Several studies have highlighted poor adherence to these recommendations, but it is unknown why this discrepancy exists. The aim of this study is assess the prevalence of pharmacoprophylaxis and characterize the practice of withholding prophylaxis. MATERIALS AND METHODS Multicenter, cross-sectional study conducted in adults admitted to a Georgia ICU at participating institutions on March 12, 2014. Data were collected on eligible patients regarding need for and omission of pharmacoprophylaxis. RESULTS Three hundred sixty-four patients across 9 institutions were included in the study. Patients had a mean age of 58 years and a median Sequential Organ Failure Assessment score of 5. Physical activity was completely bedridden or restricted in 87% of the cohort. Forty-five percent of patients were not receiving pharmacoprophylaxis. The most common reasons for withholding prophylaxis were receipt of mechanical prophylaxis, recent surgery or central nervous system bleed, and thrombocytopenia. Over 16% of the cohort was inappropriately not receiving thromboprophylaxis. Patients with an elevated international normalized ratio had lower odds of receiving prophylaxis (0.2). CONCLUSIONS Venous thromboembolism prophylaxis is commonly omitted in ICU patients, and reasons for omission vary. An elevated international normalized ratio is associated with withholding of pharmacologic prophylaxis.
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Affiliation(s)
- Anthony Hawkins
- University of Georgia College of Pharmacy, Albany, GA, USA; Augusta University Medical College of Georgia, Albany, GA, USA.
| | - Michael Mazzeffi
- University of Maryland, Department of Anesthesiology, 22 South Greene Street, S11C00, Baltimore, MD 21201, USA.
| | - Prasad Abraham
- Grady Health System, Department of Pharmacy and Drug Information, 80 Jesse Hill Jr Drive, Atlanta, GA 30303, USA.
| | - Christopher Paciullo
- Emory University Hospital, Department of Pharmaceutical Services, Atlanta, GA, USA; Mercer University College of Pharmacy, 1364 Clifton Road NE, Atlanta, GA 30322, USA.
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Schramm D, Bach AG, Meyer HJ, Surov A. Thrombotic events as incidental finding on computed tomography in intensive care unit patients. Thromb Res 2016; 141:171-4. [PMID: 27058274 DOI: 10.1016/j.thromres.2016.03.030] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Revised: 03/20/2016] [Accepted: 03/27/2016] [Indexed: 12/21/2022]
Abstract
INTRODUCTION Intensive care unit (ICU) patients are a risk group to develop thrombosis and/or thromboembolism. The purpose of this study was to analyze the frequency and localization of clinically silent thrombotic events (TE) detected on CT. MATERIALS AND METHODS From 2006 to 2013 a total of 370 patients from the ICU of our university clinic were investigated by postcontrast CT. In all cases CT was performed for detecting septic foci. There were 135 women and 235 men. CT scans included cervical, thoracic, abdominal, and pelvic regions. CT images of all patients were re-interpreted by 2 radiologists by consensus. Only thromboses detected for the first time on CT were included into the analysis. Collected data were evaluated by means of descriptive statistics. Frequencies and localizations of TE in surgical and non surgical patients were analyzed by Chi-square test. Significance level was p<0.05. RESULTS In 31.9% several TE were diagnosed. There were venous thrombosis (89.8%), cardiac thrombus (2.6%), and pulmonary embolism (7.6%). More often jugular veins were affected followed by brachiocephalic veins, and iliac veins. The frequency of TE in surgical patients was 31.1%, and 32.1% in non surgical patients. Patients after surgery had more often thrombosis of extremities veins in comparison to non surgical patients. In 61.9% of all TE the identified thrombotic complications were not diagnosed at the time of CT investigations. CONCLUSION TE can be identified in 31.9% of ICU patients as incidental finding on CT. There were venous thromboses, pulmonary embolism, and cardiac thrombus. Most frequently neck and thoracic veins were affected. 61.9% of all TE were not diagnosed at the time of CT investigations. Radiologists should check carefully CT scans for presence of different TE.
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Affiliation(s)
- Dominik Schramm
- Department of Diagnostic Radiology, Martin Luther University Halle-Wittenberg, Germany
| | - Andreas Gunter Bach
- Department of Diagnostic Radiology, Martin Luther University Halle-Wittenberg, Germany
| | - Hans Jonas Meyer
- Department of Diagnostic Radiology, Martin Luther University Halle-Wittenberg, Germany
| | - Alexey Surov
- Department of Diagnostic Radiology, Martin Luther University Halle-Wittenberg, Germany.
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Liu Y, Zhou H, Chen C, Cui C, Liu X, Liu Q, Ye M, Wang J. Assessment of the safety and efficacy of bedside ultrasound guidance for inferior vena cava filter placement in critically ill intensive care unit patients. ULTRASOUND IN MEDICINE & BIOLOGY 2015; 41:929-935. [PMID: 25701518 DOI: 10.1016/j.ultrasmedbio.2014.10.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2014] [Revised: 10/16/2014] [Accepted: 10/21/2014] [Indexed: 06/04/2023]
Abstract
Inferior vena cava filters (IVCFs) have been used clinically for approximately 45 y, but only a few studies of these devices have involved intensive care unit (ICU) patients who were critically ill and had multiple-organ dysfunction or were otherwise too unstable for transport. The purpose of this research was to assess the tolerability and efficacy of bedside ultrasound-guided IVCF placement in ICU patients. A retrospective analysis of both bedside ultrasound-guided and X-ray-guided ICVF placement was performed from November of 2011 to August of 2013. The total success rate for ultrasound-guided IVCF placement was 93.4%, which included a 96.0% success rate in 25 ICU patients with an average age of 69.46 y. Six-month follow-up studies revealed no significant differences in long-term complications between the ultrasound- and X-ray-guided groups. IVCFs may be safely implanted under ultrasound guidance in a monitored ICU environment. Our conclusion is that patients should be fasting and should receive an enema and that pre-operative surface marking and dynamic monitoring should be employed. Further research is needed to develop specific ultrasound guidelines.
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Affiliation(s)
- Ying Liu
- Ultrasound Department, Third People's Hospital of Chengdu and Second Affiliated Hospital of Chengdu, Chongqing Medical University, Chengdu City, Sichuan Province, People's Republic of China.
| | - Hong Zhou
- Ultrasound Department, Third People's Hospital of Chengdu and Second Affiliated Hospital of Chengdu, Chongqing Medical University, Chengdu City, Sichuan Province, People's Republic of China
| | - ChangYu Chen
- Ultrasound Department, Third People's Hospital of Chengdu and Second Affiliated Hospital of Chengdu, Chongqing Medical University, Chengdu City, Sichuan Province, People's Republic of China
| | - Chi Cui
- Department of Vascular Surgery, Third People's Hospital of Chengdu and Second Affiliated Hospital of Chengdu, Chongqing Medical University, Chengdu City, Sichuan Province, People's Republic of China
| | - XiPin Liu
- Radiology Department, Third People's Hospital of Chengdu and Second Affiliated Hospital of Chengdu, Chongqing Medical University, Chengdu City, Sichuan Province, People's Republic of China
| | - Qinwen Liu
- Radiology Department, Third People's Hospital of Chengdu and Second Affiliated Hospital of Chengdu, Chongqing Medical University, Chengdu City, Sichuan Province, People's Republic of China
| | - Ming Ye
- Ultrasound Department, Third People's Hospital of Chengdu and Second Affiliated Hospital of Chengdu, Chongqing Medical University, Chengdu City, Sichuan Province, People's Republic of China
| | - Jing Wang
- Ultrasound Department, Third People's Hospital of Chengdu and Second Affiliated Hospital of Chengdu, Chongqing Medical University, Chengdu City, Sichuan Province, People's Republic of China
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Eom JH, Chung SH, Shim JH. The effects of squat exercises in postures for toilet use on blood flow velocity of the leg vein. J Phys Ther Sci 2014; 26:1485-7. [PMID: 25276042 PMCID: PMC4175263 DOI: 10.1589/jpts.26.1485] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2014] [Accepted: 03/31/2014] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The purpose of this study was to identify the effects of squat exercises
performed in toilet-using postures on the blood flow velocity of the lower extremities for
the prevention of deep vein thrombosis. [Subjects] The subjects were 28 students who were
attending B University in Cheonan. They were divided into a group of 14 subjects of
sitting toilet users and a group of 14 subjects of squat toilet users. [Methods] The
subjects performed squat exercises in different toilet-using postures and we investigated
the changes in blood flow velocity. [Results] The variations in blood flow velocities
before and after the exercises showed significant differences in both groups but the
differences between the two groups were not significant. [Conclusion] Based on the results
of this study, we consider squat exercises are effective at improving the variation in
lower-extremity blood flow velocity when using a toilet.
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Affiliation(s)
- Jun Ho Eom
- Department of Physical Therapy, Baekseok University, Republic of Korea
| | - Sin Ho Chung
- Hanyang University Medical Center, Republic of Korea
| | - Jae Hun Shim
- Department of Physical Therapy, Baekseok University, Republic of Korea
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Lawall H, Oberacker R, Zemmrich C, Bramlage P, Diehm C, Schellong SM. Prevalence of deep vein thrombosis in acutely admitted ambulatory non-surgical intensive care unit patients. BMC Res Notes 2014; 7:431. [PMID: 24996222 PMCID: PMC4105515 DOI: 10.1186/1756-0500-7-431] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2014] [Accepted: 06/20/2014] [Indexed: 11/10/2022] Open
Abstract
Background Data on prevalence rates of venous thromboembolism (VTE) in different patient populations are scarce. Most studies on this topic focus on older patients or patients with malignancies, immobilization or thrombophilia. Less is known about the VTE risk profile of non-surgical patients presenting with a variety of medical diseases of differing severity. Aim of the present study was to investigate VTE prevalence in a pospective cohort study of ambulatory medical intensive care unit patients within 24 h after acute admission. Methods Prospective cohort study of 102 consecutive patients after acute admission to medical intensive care unit. Ultrasound compression sonography, APACHE-II-Scoring and laboratory examination was performed within 24 hours after admission.Possible determinants of a high risk of VTE were examined. In all patients with a confirmed diagnosis of DVT or suspicion of PE thoracic computer tomography (CT) was performed. Results VTE was found in 7.8% out of 102 of patients, mean APACHE-II-Score was 14 (mortality risk of about 15%). Thrombus location was femoropopliteal in 5 patients, iliacal in 2 and peroneal in 1 patient. Five VTE patients had concomitant PE (62.5% of VTE, 4.9% of all patients). No predictors of prevalent VTE were identified from univariable regression analysis although relative risk was high in patients with a history of smoking (RR 3.40), immobility (RR 2.50), and elevated D-Dimer levels (RR 3.49). Conclusions Prevalent VTE and concomitant PE were frequent in acutely admitted ICU patients.
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Affiliation(s)
- Holger Lawall
- Department of Angiology, Asklepios Westklinikum Hamburg, Suurheid 20, 22559 Hamburg, Germany.
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