Abstract:
AIM:To reduce the number of preventable hospital-acquired venous thromboembolic events (HA-VTE) and to improve the quality of VTE prophylaxis at multiprofile hospital. MATERIAL AND METHODS:A comprehensive approach to preventing HA-VTE was developed, which involved the global trigger tool method to assess adverse events, as well as the computerized clinical decision support system (CDSS) to prevent HA-VTE on the basis of relevant clinical practice guidelines, and HA-VTE registry. RESULTS:A total of 50 patients (15 men, 35 women; their median age was 70.5 years) with HA-VTE were included in the HA-VTE registry in January 2014 to June 2015. Assessment of a trend in the prevalence of HA-VTE when introducing CDSS to prevent VTE showed its statistically significant decline in the total number of HA-VTE cases (χ2=7.325, df=1; p=0.0068) and in that of HA-VTE in surgical patients (χ2=7.266, df=1; p=0.0070). The statistical significance of χ2 for linear trend was not achieved for medical patients, which is probably due to the small sample size (χ2=2.764, df=1; p=0.0964). While introducing CDSS, there was a statistically significant reduction in the incidence of postoperative VTE from 8.76 to 4.17 cases per 1000 interventions (χ2=5.347, df=1; p=0.0208; the absolute values of HA-VTE and surgical interventions were used for the calculation). CONCLUSION:The proposed comprehensive approach can substantially increase the detection rate of HA-VTE and decrease its incidence rates. This requires a personified assessment of the risk of VTE and hemorrhage in all hospitalized patients on day 1 of their admission, timely initiation of recommended VTE prophylaxis, and dynamic assessment of the risk of VTE and hemorrhage for timely correction of the prophylaxis. :Цель исследования. Снизить количество предотвратимых внутригоспитальных венозных тромбоэмболических осложнений (ВГ-ВТЭО) и улучшить качество профилактики ВТЭО в многопрофильном стационаре. Материалы и методы. Разработан комплексный подход к профилактике ВГ-ВТЭО, включающий метод глобальной оценки триггеров нежелательных событий, компьютерную систему поддержки принятия решений (СППР) для выбора режима профилактики ВТЭО на основе актуальных клинических руководств и регистр ВГ-ВТЭО. Результаты. Всего с января 2014 г. по июнь 2015 г. в регистр ВГ-ВТЭО включены 50 пациентов с ВГ-ВТЭО: 15 мужчин, 35 женщин, медиана возраста 70,5 года. При оценке динамики распространенности ВГ-ВТЭО на фоне внедрения СППР по профилактике ВТЭО отмечено статистически значимое снижение общего количества ВГ-ВТЭО (χ2=7,325, df=1, p=0,0068) и ВГ-ВТЭО у пациентов хирургического профиля (χ2=7,266, df=1, p=0,0070). Для пациентов терапевтического профиля статистическая значимость критерия χ2 для линейного тренда не достигнута, что, вероятно, связано с малым объемом выборки (χ2=2,764, df=1, p=0,0964). На фоне внедрения СППР отмечено статистически значимое снижение распространенности послеоперационных ВТЭО с 8,76 до 4,17 случая на 1000 вмешательств (χ2=5,347, df=1, p=0,0208, для расчета использованы абсолютные значения ВГ-ВТЭО и хирургических вмешательств). Заключение. Предложенный комплексный подход позволяет существенно увеличить частоту выявления и уменьшить частоту развития ВГ-ВТЭО. Для этого необходимы персонифицированная оценка риска развития ВТЭО и кровотечения у всех госпитализированных пациентов в 1-е сутки госпитализации, своевременное начало рекомендованной профилактики ВТЭО, проведение динамической оценки риска развития ВТЭО и кровотечений для своевременной коррекции профилактики. :Резюме Цель исследования. Снизить количество предотвратимых внутригоспитальных венозных тромбоэмболических осложнений (ВГ-ВТЭО) и улучшить качество профилактики ВТЭО в многопрофильном стационаре. Материалы и методы. Разработан комплексный подход к профилактике ВГ-ВТЭО, включающий метод глобальной оценки триггеров нежелательных событий, компьютерную систему поддержки принятия решений (СППР) для выбора режима профилактики ВТЭО на основе актуальных клинических руководств и регистр ВГ-ВТЭО. Результаты. Всего с января 2014 г. по июнь 2015 г. в регистр ВГ-ВТЭО включены 50 пациентов с ВГ-ВТЭО: 15 мужчин, 35 женщин, медиана возраста 70,5 года. При оценке динамики распространенности ВГ-ВТЭО на фоне внедрения СППР по профилактике ВТЭО отмечено статистически значимое снижение общего количества ВГ-ВТЭО (χ2=7,325, df=1, p=0,0068) и ВГ-ВТЭО у пациентов хирургического профиля (χ2=7,266, df=1, p=0,0070). Для пациентов терапевтического профиля статистическая значимость критерия χ2 для линейного тренда не достигнута, что, вероятно, связано с малым объемом выборки (χ2=2,764, df=1, p=0,0964). На фоне внедрения СППР отмечено статистически значимое снижение распространенности послеоперационных ВТЭО с 8,76 до 4,17 случая на 1000 вмешательств (χ2=5,347, df=1, p=0,0208, для расчета использованы абсолютные значения ВГ-ВТЭО и хирургических вмешательств). Заключение. Предложенный комплексный подход позволяет существенно увеличить частоту выявления и уменьшить частоту развития ВГ-ВТЭО. Для этого необходимы персонифицированная оценка риска развития ВТЭО и кровотечения у всех госпитализированных пациентов в 1-е сутки госпитализации, своевременное начало рекомендованной профилактики ВТЭО, проведение динамической оценки риска развития ВТЭО и кровотечений для своевременной коррекции профилактики.
journal_name
Ter Arkhjournal_title
Terapevticheskii arkhivauthors
Nazarenko GI,Kleymenova EB,Payushchik SA,Otdelеnov VA,Sychev DAdoi
10.17116/terarkh201688923-30subject
Has Abstractpub_date
2016-01-01 00:00:00pages
23-30issue
9eissn
0040-3660issn
2309-5342journal_volume
88pub_type
杂志文章abstract::The content of IgA, IgM, IgG and IgE was measured in 55 male patients with uncomplicated essential hypertension (EH) running a labile course (25 patients) and a stable course (30 patients). Analyzing the material, account was taken of aggravated heredity factor as regards arterial hypertension, established according t...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1991-01-01 00:00:00
abstract::The paper discusses current approaches to diagnosing in an internal medicine clinic and to improving diagnostic tactics. It gives prospects for training physicians in current diagnostic approaches in the framework of the continuing medical education system. ...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:2014-01-01 00:00:00
abstract:AIM:To assess efficacy and safety of selective beta-adrenoblockers (BAB) metoprolol succinate and nebivolol in patients with arterial hypertension (AH) and/or IHD associated with bronchoobstructive syndrome (BOS). MATERIAL AND METHODS:Fifty patients suffering from AH and/or IHD associated with BOS in chronic obstructi...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:2007-01-01 00:00:00
abstract:AIM:To study nebivolol efficacy in pregnant and puerperal women with hypertension. MATERIAL AND METHODS:Monitoring of endothelial function, central and peripheral hemodynamics (HD), myocardial function, intrarenal circulation and microalbuminuria (MAU) was performed in 90 pregnant (67 hypertensive and 23 normotensive)...
journal_title:Terapevticheskii arkhiv
pub_type: 临床试验,杂志文章
doi:
更新日期:2006-01-01 00:00:00
abstract:AIM:The retrospective analysis of prevalence, peculiarities of duration of biliary calculosis without gall bladder cholesterosis, biliary calculosis with gall-bladder cholesterosis and xanthogranulematous cholecystitis among persons who underwent cholecystectomy using clinical, instrumental and morphological data. MATE...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:2008-01-01 00:00:00
abstract:AIM:To characterize coronary arteries and myocardial perfusion in isolated ischemic heart disease (IHD) and IHD combined with blood hypertension (BH). MATERIALS AND METHODS:20 patients with isolated IHD and 25 patients with combined IHD have undergone coronarography, scintigraphy of the myocardium with Tc-99m, echocar...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1999-01-01 00:00:00
abstract::The authors observed a patient with bronchial asthma who developed acute pulmonary pyodestruction with generalization of the infection, a splenic abscess and drug allergy against prolonged corticosteroid therapy. Diagnostic potentialities, necessary intensive care measures and long-term effects of these complications ...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1988-01-01 00:00:00
abstract:AIM:The aim of the study is to determine the prevalence of AO in the population and to assess the association with socioeconomic factors according to the data of the ESSE-RF study (Epidemiology of Cardiovascular diseases in the Regions of the Russian Federation). MATERIALS AND METHODS:The object of the study is a rand...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:10.26442/terarkh2018901014-22
更新日期:2018-11-22 00:00:00
abstract:AIM:To investigate verbal dyspnea characteristics in patients with bronchial asthma (BA) and hyperventilation syndrome (HVS). MATERIAL AND METHODS:The trial covered 52 patients with BA, 10 patients with BA combination with HVS and 18 patients with HVS. Verbal dyspnea characteristics were studied with PM. Simon questio...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:2012-01-01 00:00:00
abstract:AIM:To discover relations between allergic diseases and H. pylori infection in patients with gastroduodenal diseases. MATERIAL AND METHODS:The study was made of 113 patients (age 22-65, 34 males and 79 females) with chronic gastritis and duodenal ulcer. Of them, 60 patients (group 1) had concomitant allergy (urticaria...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:2008-01-01 00:00:00
abstract:AIM:To determine sensitivity and specificity of stress echocardiography (SEC) in diagnosis of stenosing atherosclerosis of coronary arteries (CA), especially in patients recovered from Q-myocardial infarction. MATERIAL AND METHODS:The above sensitivity and specificity were studied in 75 patients (70 males and 5 female...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:2004-01-01 00:00:00
abstract::The analysis of literature and data obtained by the authors validate the necessity to recognize early atherosclerosis as a specific form of low limb vascular lesions. The latter are characterized by the presence of autoimmune inflammation in the vascular wall. The authors believe peripheral nonspecific aortic arteriti...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章,评审
doi:
更新日期:1994-01-01 00:00:00
abstract:AIM:To ascertain whether high arterial rigidity is obligatory in arterial hypertension (AH) and the presence of AH is obligatory in patients with rigid arteries. MATERIAL AND METHODS:Volume sphygmography (VS) was made in 153 patients aged 60-86 years: 96 patients with untreated AH of degree 1-3 (40 males aged 71.0 +/-...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:2011-01-01 00:00:00
abstract::Clinico-morphological correlations in non-Hodgkin's splenic lymphomas (NHL) have shown that a clinical course and hematological symptoms of splenic NHL correlate with a morphological variant of disease. Blast forms have a more aggressive course. Data on the clinical pathomorphosis of splenic NHL after splenectomy sugg...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1987-01-01 00:00:00
abstract::Overall 30 patients with multiple myeloma (MM) were examined for immunological and rheological parameters. MM was shown to be marked by imbalance of immunobiological reactivity, with the greatest changes being seen in the B cell immunity system. MM is also characterized by marked rheological shifts related to the immu...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1991-01-01 00:00:00
abstract:AIM:To devise the technique and evaluate the efficacy of videothoracoscopic collagen pleurodesis (VCP) in malignant pleural exudates (MPE). MATERIAL AND METHODS:VCP was performed in 24 patients with recurrent MPE. 20 patients were diagnosed to have non-small-cell cancer of the lung, 4 patients--breast cancer. The oper...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:2004-01-01 00:00:00
abstract::The status of the blood kinin system, activity of serum inhibitors of proteinases (alpha 1-protease inhibitor and alpha 2-macroglobulin) as well as indices of activity of trypsin-like proteinases, elastolytic and fibrinolytic activity, free antitryptic activity and complete content of acid stable inhibitors were studi...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1988-01-01 00:00:00
abstract:AIM:To determine clinical efficiency and tolerance of paxil (paroxetin) in the treatment of panic disorders. MATERIAL AND METHODS:An open, non-comparative 7 week study entered 60 patients (mean age 36.6 +/- 3.22 years) with panic disorders and agoraphobias with panic disorders. Paroxetin was given in a single daily do...
journal_title:Terapevticheskii arkhiv
pub_type: 临床试验,杂志文章,多中心研究
doi:
更新日期:2000-01-01 00:00:00
abstract:AIM:To evaluate 24-hour dynamics of the arterial stiffness main indicators in patients with bronchial asthma of various severity and control. MATERIALS AND METHODS:The study included 119 patients with bronchial asthma, who formed main groups: the first group 48 patients with mild and moderate asthma, the second 71 pat...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:10.26442/00403660.2020.03.000438
更新日期:2020-04-27 00:00:00
abstract::Hemocoagulation was examined in 477 diabetes mellitus patients. Whatever the disease type, severity, duration and the intensity of microvascular complications, diabetes mellitus was discovered to be marked by the development of chronic intravascular blood microcoagulation associated with primary hyperactivation of the...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1991-01-01 00:00:00
abstract:AIM:To compare efficacy and safety of atenolol, methoprolol and bisoprolol, as the most usable beta-blockers, in patients with isolated systolic arterial hypertension (ISAH) and concomitant diabetes mellitus (DM) and/or chronic obstructive pulmonary disease (COPD). MATERIAL AND METHODS:Forty tow patients with ISAH and...
journal_title:Terapevticheskii arkhiv
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:2003-01-01 00:00:00
abstract:AIM:To investigate the impact of double filtration plasmapheresis (DFPP) and therapeutic plasma exchange (TPE) on hemostasis in renal transplant recipients. MATERIALS AND METHODS:54 renal transplant patients with an acute humoral rejection were treated with therapeutic apheresis methods: 24 patients with DFPP and 30 p...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:10.26442/terarkh201890622-27
更新日期:2018-06-20 00:00:00
abstract::The paper is concerned with the data on the brain stroke incidence and lethality among the population aged 25-64 years in 3 districts of Moscow during 1985. The rate of brain stroke was noted to be increased with age without any essential differences in the indicators in men and women. Comparison of the results of the...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1989-01-01 00:00:00
abstract:UNLABELLED:AID: To investigate the role of suprasegmental (anxious disorders) and segmental vegetative disorders (dysfunction of neuromuscular transmission and cutaneous microcirculation) in pathogenesis of muscular syndrome of rheumatoid arthritis (RA). MATERIAL AND METHODS:MMPI, Beck's questionnaire, Spilberger's te...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:2002-01-01 00:00:00
abstract::The authors review literature data on application of impulsed magnetic field (IMF) in clinical practice. IMF introduction in LE treatment is thought beneficial because IMF antiinflammatory, analgetic effects, positive action on microcirculation, immunological reactivity, the ability to upgrade the effect of combined t...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1995-01-01 00:00:00
abstract:AIM:To investigate effects of trimetazidine and perindopril on myocardial function and metabolism in patients with cardiac failure after myocardial infarction. MATERIAL AND METHODS:A comparative study was mode of the effects of 6-month therapy with perindopril, trimetazidine alone and in combination on clinical sympto...
journal_title:Terapevticheskii arkhiv
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:2003-01-01 00:00:00
abstract::Sandimmun (ciclosporin A) treatment of chronic glomerulonephritis with nephrotic syndrome in a dose 2.5-5 mg/kg for 6-10 months relieved nephrotic syndrome in 2 and resulted in clinical improvement in other 2 of 4 patients treated. In 3 cases the patients failed previous therapy with high-dose corticosteroids and cyto...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1995-01-01 00:00:00
abstract::Hemodynamic studies in 226 patients with erysipelas of the lower limbs with employment of tetrapolar rheography revealed a marked reduction in the intensity of regional blood flow correlated with the disease severity. Circulation recovery in the affected limb takes place as late as 3 months after the discharge from ho...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1993-01-01 00:00:00
abstract::The authors present literature data and original findings on characteristics and frequency of hematological disorders in SLE. Marked hemopathies are called SLE masks as in primary examination of the patient systemic blood diseases are not rejected this necessitating special investigations to exclude them. A rare case ...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章,评审
doi:
更新日期:1997-01-01 00:00:00
abstract::Seventy patients with pectus carinatum were examined. All the patients demonstrated the minimal signs of connective tissue deficiency. The ECG readings showed incomplete blockade of the bundle of His, ventricular extrasystole, WPW and CLC syndromes, and metabolic alterations in the myocardium. Mitral valve prolapse wa...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1990-01-01 00:00:00