背景技术癌症是众所周知的可预防的血栓栓塞性疾病的危险因素。这项研究旨在为癌症相关血栓形成(CT)的预防和管理提供指导,为向沙特阿拉伯医疗机构就诊的内科和外科肿瘤患者提供预防和治疗选择。方法本共识与改进的基于德尔菲的方法相一致,其中包括两轮投票之间的面对面会议,以获得专家对拟议声明的反馈。所有专家要么是肿瘤学家,血液学家,或血液肿瘤学专家,在血液肿瘤学中具有积极的临床和研究概况。结果专家们强调,沙特人口中遗传性血栓形成倾向的发生率相对较高,这可能是沙特王国CT负担高于世界其他地区的原因。然而,由于缺乏评估沙特阿拉伯CT的文献,原发性静脉血栓栓塞的预防应根据对癌症患者的有效风险评估进行调整,并应在常规实践中实施。对于住院的肿瘤患者,专家们一致认为,应该提供低分子量肝素(LMWH)的预防,不管急性疾病的存在。对于门诊内科肿瘤患者,对于高危患者,应提供LMWH或直接口服抗凝剂(DOAC)预防。关于手术患者,他们一致认为,所有接受手术的肿瘤患者都应接受血栓预防.在二级预防方面,专家建议继续使用预防剂量的抗凝剂(LMWH或DOAC),根据癌症类型和阶段的适当时间。最后,他们还提供了一套关于沙特阿拉伯CT管理的声明。结论本改良的基于德尔菲的研究将现有的最佳证据和临床经验与沙特阿拉伯当前的医疗保健政策和环境相结合,就流行病学问题达成共识。预防,和CT的管理。
Background Cancer is a well-known risk factor of preventable thromboembolic disease. This study aims to provide guidance on the prevention and management of cancer-associated thrombosis (CT) that tailors prophylactic and therapeutic options for medical and surgical oncology patients presenting to health care settings in Saudi Arabia. Methods The present
consensus was developed in concordance with the modified Delphi-based approach, which incorporates a face-to-face meeting between two voting rounds to gain experts\' feedback on the proposed statements. All experts were either oncologists, hematologists, or hemato-oncologist with an active clinical and research profile in hemato-oncology. Results The experts highlighted that the comparatively high incidence of inherited thrombophilia among the Saudi population may account for a higher CT burden in the Kingdom than in other parts of the world. However, due to the lack of literature that assesses CT in Saudi Arabia, primary venous thromboembolism prophylaxis should be tailored according to a valid risk assessment of cancer patients and should be implemented in routine practice. For hospitalized medical oncology patients, the experts agreed that prophylaxis with low-molecular-weight heparin (
LMWH) should be offered, regardless of the presence of acute illness. For ambulatory medical oncology patients,
LMWH or direct oral anticoagulants (DOACs) prophylaxis should be offered for high-risk patients. Concerning surgical patients, they agreed that all oncology patients undergoing surgery should be offered thromboprophylaxis. In terms of secondary prophylaxis, the experts recommended continuing a prophylactic dose of anticoagulant (
LMWH or DOAC), for an appropriate period depending on the cancer type and stage. Finally, they also provided a set of statements on management of CT in Saudi Arabia. Conclusion The present modified Delphi-based study combined the best available evidence and clinical experience with the current health care policies and settings in Saudi Arabia to build a
consensus statement on the epidemiology, prevention, and management of CT.