Long-Term Outcomes of Post-Surgical Deep-Vein Thrombosis in Asia: The AIDA-Extension Study.
Notice bibliographique
Résumé
Abstract Background: We have recently demonstrated in a large multinational, multiethnic study that the incidence of venographic deep-vein thrombosis (DVT) in Asian patients undergoing major orthopedic surgery of the lower limbs and not receiving thromboprophylaxis was similar to that observed in orthopedic patients in Western countries. Overall, 407 patients (20–99 years) undergoing THR (n=175), TKR (n=136) or HFS (n= 96) were recruited in 19 centres across Asia (Indonesia, South Korea, Malaysia, Philippines, Taiwan and Thailand). 72.5% of the enrolled patients had adequate venograms. Total DVT was diagnosed in 121 of 295 evaluable patients (41.0%, [95% confidence interval: 35.4–46.7]). Proximal DVT was found in 30 patients (10.2% [7.0–14.2]). However the long-term outcomes following deep vein thrombosis such as recurrence of DVT, incidence of pulmonary embolism (PE), and post-thrombotic syndrome (PTS) remain unknown. PTS has received little attention in the literature, and particularly in Asia. Objectives: To assess the long-term complication rates (at 1 and 2 years) of patients with objectively assessed DVT compared to those observed in patients without post-operative DVT. Methods: Annual visits were performed to record the occurrence of DVT/PE, incidence of PTS, cumulative incidence rates and related predictive factors. PTS scoring were assessed using the Villalta scale (signs and symptoms). In addition in a subset of 18 out of 27 (66%) patients from South Korea with centrally adjudicated venographic DVT, a second venogram was performed at 1 year in order to verify possible spontaneous modifications of the thrombus (none of these patients had undergone any anticoagulant treatment). Results: From the 332 patients having completed the AIDA study in the 19 centres involved in the extension study, 236 patients (71.1%) agreed to participate in the extension phase and were assessed at year 1. Year 2 follow up visits were completed in May 2005. Complete data analysis of the final study results are ongoing and should be completed by September 2005. Of the 18 patients who underwent a second follow-up bilateral or unilateral ascending venography at 1 year ± 3 months post-operatively, 11 (61%) patients demonstrated resolution of the thrombus, with 3 (16%) patients showing incomplete resolution or persistence of the venous thrombosis. The venograms of the remaining four (23%) patients presented with development of collateral circulation confirming the progressive state of PTS. The majority of patients with centrally adjudicated venographic DVT demonstrated positive resolution following venographic assessment at year 1. The high incidence of thrombus resolution may have been due to the fact that most patients were diagnosed with distal DVT, which would suggest that a high percentage of DVT of the distal veins may resolve spontaneously compared to other types of DVT.
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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 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,000 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,001 |
| 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 ».