PDF(Pubmed)
Abstract：
UNASSIGNED: There are no studies to date that examine the association between anti-factor-Xa (AFXa)-based heparin monitoring and clinical outcomes in the setting of cerebral venous thrombosis (CVT).
UNASSIGNED: This pilot study included adults aged ≥18 admitted with CVT between 1 January 2018 and 1 January 2021, who were treated with unfractionated heparin (UFH) and were monitored via AFXa-based nomogram within 24 h of arrival. Comparisons were made between patients with AFXa levels within the target therapeutic range (0.25-0.5 IU/mL) and patients whose levels were not within the therapeutic range within 24 h of arrival; the time (hours) from arrival to reach the therapeutic range was also examined. Outcomes were length of stay (LOS) in the hospital, major (actionable) bleeding events, and discharge home (vs. higher acuity location). Continuous data are reported in the form of the median (interquartile range).
UNASSIGNED: Among 45 patients, treatment with UFH was initiated 2 (1-11) h after arrival, and the majority (84%) of UFH infusions did not need dose adjustment. AFXa assays were conducted every 6 (5.5-7) h. Thirty patients (67%) fell within the therapeutic range. Outcomes were similar for patients with levels within the therapeutic range vs. not: major bleeding events, 10% vs. 0% (p = 0.54); discharge home, 77% vs. 80% (p = 1.0); LOS, 5 days in each group (p = 0.95). There was also no association between outcomes and time to reach the therapeutic range.
UNASSIGNED: Our findings demonstrate the practicability of monitoring UFH based on AFXa values in this population of patients with CVT, but reaching target AFXa levels within 24 h of arrival may not necessarily be prognostic.
UNASSIGNED: This pilot study included adults aged ≥18 admitted with CVT between 1 January 2018 and 1 January 2021, who were treated with unfractionated heparin (UFH) and were monitored via AFXa-based nomogram within 24 h of arrival. Comparisons were made between patients with AFXa levels within the target therapeutic range (0.25-0.5 IU/mL) and patients whose levels were not within the therapeutic range within 24 h of arrival; the time (hours) from arrival to reach the therapeutic range was also examined. Outcomes were length of stay (LOS) in the hospital, major (actionable) bleeding events, and discharge home (vs. higher acuity location). Continuous data are reported in the form of the median (interquartile range).
UNASSIGNED: Among 45 patients, treatment with UFH was initiated 2 (1-11) h after arrival, and the majority (84%) of UFH infusions did not need dose adjustment. AFXa assays were conducted every 6 (5.5-7) h. Thirty patients (67%) fell within the therapeutic range. Outcomes were similar for patients with levels within the therapeutic range vs. not: major bleeding events, 10% vs. 0% (p = 0.54); discharge home, 77% vs. 80% (p = 1.0); LOS, 5 days in each group (p = 0.95). There was also no association between outcomes and time to reach the therapeutic range.
UNASSIGNED: Our findings demonstrate the practicability of monitoring UFH based on AFXa values in this population of patients with CVT, but reaching target AFXa levels within 24 h of arrival may not necessarily be prognostic.
摘要：
■迄今为止，尚无研究检查在脑静脉血栓形成（CVT）背景下基于抗因子-Xa（AFXa）的肝素监测与临床结局之间的关联。
■这项试点研究包括2018年1月1日至2021年1月1日期间接受CVT治疗的18岁以上成年人，他们接受普通肝素（UFH）治疗，并在到达24小时内通过基于AFXa的列线图进行监测。在AFXa水平在目标治疗范围（0.25-0.5IU/mL）内的患者和在到达后24小时内水平不在治疗范围内的患者之间进行比较；还检查了从到达达到治疗范围的时间（小时）。结果是住院时间（LOS），主要（可操作）出血事件，并出院回家(与更高的敏锐度位置)。连续数据以中值(四分位间距)的形式报告。
■在45名患者中，到达后2（1-11）h开始UFH治疗，大多数(84%)UFH输注不需要调整剂量.每6(5.5-7)小时进行AFXa测定。30名患者(67%)落在治疗范围内。水平在治疗范围内的患者的结果相似。不是：大出血事件，10%vs.0%(p=0.54)；出院回家，77%vs.80%(p=1.0)；LOS，每组5天(p=0.95)。结果与达到治疗范围的时间之间也没有关联。
■我们的研究结果表明，在CVT患者人群中，基于AFXa值监测UFH的实用性，但在到达后24小时内达到目标AFXa水平可能不一定是预后。
■这项试点研究包括2018年1月1日至2021年1月1日期间接受CVT治疗的18岁以上成年人，他们接受普通肝素（UFH）治疗，并在到达24小时内通过基于AFXa的列线图进行监测。在AFXa水平在目标治疗范围（0.25-0.5IU/mL）内的患者和在到达后24小时内水平不在治疗范围内的患者之间进行比较；还检查了从到达达到治疗范围的时间（小时）。结果是住院时间（LOS），主要（可操作）出血事件，并出院回家(与更高的敏锐度位置)。连续数据以中值(四分位间距)的形式报告。
■在45名患者中，到达后2（1-11）h开始UFH治疗，大多数(84%)UFH输注不需要调整剂量.每6(5.5-7)小时进行AFXa测定。30名患者(67%)落在治疗范围内。水平在治疗范围内的患者的结果相似。不是：大出血事件，10%vs.0%(p=0.54)；出院回家，77%vs.80%(p=1.0)；LOS，每组5天(p=0.95)。结果与达到治疗范围的时间之间也没有关联。
■我们的研究结果表明，在CVT患者人群中，基于AFXa值监测UFH的实用性，但在到达后24小时内达到目标AFXa水平可能不一定是预后。
