{"title":"严重外伤性脑损伤术后下肢深静脉血栓形成的危险因素：系统回顾和荟萃分析。","authors":"Min-Ling Mo, Ya-Juan Zhang, Da-Hong Zhai, Xiao-Shan Li, Ying Zhu, Gu-Qing Zeng","doi":"10.1097/SHK.0000000000002676","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>This study aims to systematically evaluate the risk factors associated with the development of postoperative lower extremity deep venous thrombosis (LEDVT) in patients with severe traumatic brain injury (sTBI).</p><p><strong>Methods: </strong>A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Comprehensive searches of Chinese and English databases, including PubMed, Cochrane Library, Embase, China National Knowledge Infrastructure, and Wanfang, were conducted from inception to December 12, 2024. Two researchers independently screened articles and extracted relevant data. Study quality was assessed using the Newcastle-Ottawa Scale and the Agency for Healthcare Research and Quality criteria. Meta-analyses were performed using RevMan 5.3, applying a random-effects model to combine effect sizes, with subsequent sensitivity analyses and assessments for publication bias. The review was registered in PROSPERO (CRD42024629624).</p><p><strong>Results: </strong>A total of 13 studies (n = 777,327) were included, comprising 8 case-control studies, 2 cohort studies, and 3 cross-sectional studies. Eleven significant risk factors for postoperative LEDVT were identified: advanced age (odds ratio [OR] = 1.12, 95% confidence interval [CI]: 1.10-1.14), use of dehydrant (OR = 2.04, 95% CI: 1.38-3.04), mechanical ventilation (OR = 1.01, 95% CI: 1.01-1.02), elevated D-dimer level (OR = 1.19, 95% CI: 1.11-1.27), polytrauma (OR = 1.63, 95% CI: 1.29-2.03), hypertension (OR = 1.11, 95% CI: 1.07-1.15), surgical duration (OR = 1.60, 95% CI: 1.06-2.42), elevated body mass index (OR = 1.30, 95% CI: 1.16-1.45), deep venous catheterization (OR = 1.36, 95% CI: 1.15-1.60), length of hospital stay (OR = 1.36, 95% CI: 1.18-1.56), and blood transfusion (OR = 3.56, 95% CI: 1.91-6.63), with all p values <0.05. No statistically significant associations were observed for Glasgow Coma Scale score (OR = 1.12, 95% CI: 0.98-1.28) or diabetes mellitus (OR = 1.02, 95% CI: 0.97-1.07).</p><p><strong>Conclusions: </strong>Eleven variables were identified as significant risk factors for postoperative LEDVT among patients with sTBI. These findings underscore the importance of implementing individualized preventive strategies for patients identified as high risk.</p>","PeriodicalId":21667,"journal":{"name":"SHOCK","volume":" ","pages":""},"PeriodicalIF":2.9000,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Risk Factors for Postoperative Lower Extremity Deep Venous Thrombosis Following Severe Traumatic Brain Injury: A Systematic Review and Meta-Analysis.\",\"authors\":\"Min-Ling Mo, Ya-Juan Zhang, Da-Hong Zhai, Xiao-Shan Li, Ying Zhu, Gu-Qing Zeng\",\"doi\":\"10.1097/SHK.0000000000002676\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>This study aims to systematically evaluate the risk factors associated with the development of postoperative lower extremity deep venous thrombosis (LEDVT) in patients with severe traumatic brain injury (sTBI).</p><p><strong>Methods: </strong>A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Comprehensive searches of Chinese and English databases, including PubMed, Cochrane Library, Embase, China National Knowledge Infrastructure, and Wanfang, were conducted from inception to December 12, 2024. Two researchers independently screened articles and extracted relevant data. Study quality was assessed using the Newcastle-Ottawa Scale and the Agency for Healthcare Research and Quality criteria. Meta-analyses were performed using RevMan 5.3, applying a random-effects model to combine effect sizes, with subsequent sensitivity analyses and assessments for publication bias. The review was registered in PROSPERO (CRD42024629624).</p><p><strong>Results: </strong>A total of 13 studies (n = 777,327) were included, comprising 8 case-control studies, 2 cohort studies, and 3 cross-sectional studies. Eleven significant risk factors for postoperative LEDVT were identified: advanced age (odds ratio [OR] = 1.12, 95% confidence interval [CI]: 1.10-1.14), use of dehydrant (OR = 2.04, 95% CI: 1.38-3.04), mechanical ventilation (OR = 1.01, 95% CI: 1.01-1.02), elevated D-dimer level (OR = 1.19, 95% CI: 1.11-1.27), polytrauma (OR = 1.63, 95% CI: 1.29-2.03), hypertension (OR = 1.11, 95% CI: 1.07-1.15), surgical duration (OR = 1.60, 95% CI: 1.06-2.42), elevated body mass index (OR = 1.30, 95% CI: 1.16-1.45), deep venous catheterization (OR = 1.36, 95% CI: 1.15-1.60), length of hospital stay (OR = 1.36, 95% CI: 1.18-1.56), and blood transfusion (OR = 3.56, 95% CI: 1.91-6.63), with all p values <0.05. No statistically significant associations were observed for Glasgow Coma Scale score (OR = 1.12, 95% CI: 0.98-1.28) or diabetes mellitus (OR = 1.02, 95% CI: 0.97-1.07).</p><p><strong>Conclusions: </strong>Eleven variables were identified as significant risk factors for postoperative LEDVT among patients with sTBI. These findings underscore the importance of implementing individualized preventive strategies for patients identified as high risk.</p>\",\"PeriodicalId\":21667,\"journal\":{\"name\":\"SHOCK\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":2.9000,\"publicationDate\":\"2025-07-25\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"SHOCK\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1097/SHK.0000000000002676\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"CRITICAL CARE MEDICINE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"SHOCK","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/SHK.0000000000002676","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CRITICAL CARE MEDICINE","Score":null,"Total":0}
Risk Factors for Postoperative Lower Extremity Deep Venous Thrombosis Following Severe Traumatic Brain Injury: A Systematic Review and Meta-Analysis.
Objective: This study aims to systematically evaluate the risk factors associated with the development of postoperative lower extremity deep venous thrombosis (LEDVT) in patients with severe traumatic brain injury (sTBI).
Methods: A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Comprehensive searches of Chinese and English databases, including PubMed, Cochrane Library, Embase, China National Knowledge Infrastructure, and Wanfang, were conducted from inception to December 12, 2024. Two researchers independently screened articles and extracted relevant data. Study quality was assessed using the Newcastle-Ottawa Scale and the Agency for Healthcare Research and Quality criteria. Meta-analyses were performed using RevMan 5.3, applying a random-effects model to combine effect sizes, with subsequent sensitivity analyses and assessments for publication bias. The review was registered in PROSPERO (CRD42024629624).
Results: A total of 13 studies (n = 777,327) were included, comprising 8 case-control studies, 2 cohort studies, and 3 cross-sectional studies. Eleven significant risk factors for postoperative LEDVT were identified: advanced age (odds ratio [OR] = 1.12, 95% confidence interval [CI]: 1.10-1.14), use of dehydrant (OR = 2.04, 95% CI: 1.38-3.04), mechanical ventilation (OR = 1.01, 95% CI: 1.01-1.02), elevated D-dimer level (OR = 1.19, 95% CI: 1.11-1.27), polytrauma (OR = 1.63, 95% CI: 1.29-2.03), hypertension (OR = 1.11, 95% CI: 1.07-1.15), surgical duration (OR = 1.60, 95% CI: 1.06-2.42), elevated body mass index (OR = 1.30, 95% CI: 1.16-1.45), deep venous catheterization (OR = 1.36, 95% CI: 1.15-1.60), length of hospital stay (OR = 1.36, 95% CI: 1.18-1.56), and blood transfusion (OR = 3.56, 95% CI: 1.91-6.63), with all p values <0.05. No statistically significant associations were observed for Glasgow Coma Scale score (OR = 1.12, 95% CI: 0.98-1.28) or diabetes mellitus (OR = 1.02, 95% CI: 0.97-1.07).
Conclusions: Eleven variables were identified as significant risk factors for postoperative LEDVT among patients with sTBI. These findings underscore the importance of implementing individualized preventive strategies for patients identified as high risk.
期刊介绍：
SHOCK®: Injury, Inflammation, and Sepsis: Laboratory and Clinical Approaches includes studies of novel therapeutic approaches, such as immunomodulation, gene therapy, nutrition, and others. The mission of the Journal is to foster and promote multidisciplinary studies, both experimental and clinical in nature, that critically examine the etiology, mechanisms and novel therapeutics of shock-related pathophysiological conditions. Its purpose is to excel as a vehicle for timely publication in the areas of basic and clinical studies of shock, trauma, sepsis, inflammation, ischemia, and related pathobiological states, with particular emphasis on the biologic mechanisms that determine the response to such injury. Making such information available will ultimately facilitate improved care of the traumatized or septic individual.
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