Prevalence and Incidence of Arterial and Venous Thrombosis in Critically Ill Patients.
Notice bibliographique
Résumé
Abstract Background: Critically ill patients have multiple risk factors for developing thrombosis, yet little is known about the prevalence and incidence of arterial and venous thrombotic events in this patient population. The development of thrombosis is likely to be frequently unrecognized and thus untreated, which may affect clinical outcomes. Purpose: To document the prevalence and incidence of clinically recognized thrombotic events in critically ill adult patients. Methods: We undertook a retrospective chart review of 208 patients from a cohort of 261 critically ill patients admitted to a medical-surgical intensive care unit (ICU) who were enrolled in a prospective cohort study evaluating the prevalence and incidence of deep vein thrombosis (DVT) using twice weekly ultrasound screening. All other thrombotic events were diagnosed based on clinical suspicion and confirmed by conventional diagnostic tests. Data extraction: We reviewed daily medical records during the patient’s ICU admission for signs and symptoms of thrombosis, and abstracted laboratory and radiologic data. Results: At the time of ICU admission, ultrasound screening revealed DVT in 7 of 261 patients (prevalence 2.7%, 95% CI 1.1–5.4%) but only 3 cases (42.9%) were clinically suspected. During the ICU stay, 25 patients developed DVT (incidence 9.6%, 95% CI 6.3–13.8%), but only 3 (12.0%) were clinically suspected. Pulmonary embolism was clinically recognized on admission in 4 of 208 patients (prevalence 1.9%, 95% CI 0.5–4.9%); and was diagnosed in 1 patient during ICU stay (incidence 0.5%, 95% CI 0.0–2.6%). For arterial events, 3 of 208 patients were admitted with ischemic stroke, and 3 developed this complication in the ICU (prevalence and incidence 1.4%, 95% CI 0.3–4.2%). Cardiac troponin I was measured at least once in the first 24 hours of admission in 90% of patients. Elevated cardiac troponin I levels were observed in 69 of 208 patients on admission to ICU (prevalence 33.2%, 95% CI 26.8–40.0%) and 15 patients developed elevations in cardiac troponin I during their ICU stay (incidence 7.2%, 95% CI 4.1–11.6%). A diagnosis of an acute coronary syndrome (ACS) (based on troponin I level, and either ECG changes or initiation of treatment for myocardial ischemia) was made in 54 of 208 patients (prevalence 26.0%, 95% CI 20.1–32.5%). Fifteen patients (7.2%, 95% 4.1–11.6%) had elevated cardiac troponin I levels without any further testing. During the ICU stay, the incidence of ACS was 5.3% (95% CI 2.7–9.3%) and isolated elevated troponin I levels were found in 1.9% (95% CI 0.5–4.9%). Conclusions: Thrombotic events in critically ill patients occurs frequently and may often be unrecognized. Typical diagnostic tests for thromboembolism have not been properly evaluated in the critically ill; moreover, the predictive value for the diagnosis of myocardial infarction has not been determined in these patients. Additional studies evaluating the long term outcome and efficacy of interventions for critically ill patients with thrombotic events is required.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,003 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».