PDF(Pubmed)
Abstract：
Antithrombotics have been widely used to treat and prevent COVID-19-related thrombosis; however, studies on their use at population levels are limited. We aimed to describe antithrombotic use patterns during the pandemic in Spanish primary care and hospital-admitted patients with COVID-19. Methods: A real-world data study was performed. Data were obtained from BIFAP\'s electronic health records. We investigated the antithrombotic prescriptions made within ±14 days after diagnosis between March 2020 and February 2022, divided their use into prior and new/naive groups, and reported their post-discharge use. Results: We included 882,540 individuals (53.4% women), of whom 78,499 were hospitalized. The median age was 44.7 (IQR 39-59). Antithrombotics were prescribed in 37,183 (4.6%) primary care subjects and 42,041 (53.6%) hospital-admitted patients, of whom 7505 (20.2%) and 20,300 (48.3%), respectively, were naive users. Prior users were older and had more comorbidities than new users. Enoxaparin was the most prescribed antithrombotic in hospitals, with higher prescription rates in new than prior users (2348.2, IQR 2390-3123.1 vs. 1378, IQR 1162-1751.6 prescriptions per 10,000 cases, p = 0.002). In primary care, acetylsalicylic acid was the most used antithrombotic, with higher use rates in prior than in naïve users. Post-discharge use occurred in 6686 (15.9%) subjects (median use = 10 days, IQR 9-30). Conclusions: Our study identified a consensus on prescribing antithrombotics in COVID-19 patients, but with low use rates in hospitals.
摘要：
抗血栓药物已广泛用于治疗和预防COVID-19相关的血栓形成；然而，关于它们在人口水平上的使用的研究是有限的。我们的目的是描述西班牙初级保健和住院COVID-19患者在大流行期间的抗血栓使用模式。方法：进行了真实世界的数据研究。数据来自BIFAP的电子健康记录。我们调查了2020年3月至2022年2月之间诊断后±14天内的抗血栓处方，将其分为先前和新/幼稚组，并报告了他们出院后的使用情况。结果：我们包括882,540名个体（53.4％的女性），其中78,499人住院。中位年龄为44.7岁（IQR39-59）。在37,183（4.6％）初级保健受试者和42,041（53.6％）住院患者中规定了抗血栓药，其中7505人(20.2%)和20,300人(48.3%)，分别,是天真的用户。与新用户相比，以前的用户年龄更大，并且有更多的合并症。依诺肝素是医院处方最多的抗血栓药物，新用户的处方率高于以前的用户(2348.2，IQR2390-3123.1与1378，IQR1162-1751.6处方/10,000例，p=0.002)。在初级保健中，乙酰水杨酸是最常用的抗血栓药，在之前的使用率高于天真的用户。出院后使用发生在6686名（15.9%）受试者中（使用中位数=10天，IQR9-30）。结论：我们的研究确定了在COVID-19患者中处方抗血栓药物的共识，但医院使用率低。
