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首页> 外文期刊>Internal medicine journal >Variation in the use of recombinant activated factor VII in critical bleeding.
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Variation in the use of recombinant activated factor VII in critical bleeding.

机译：在重症出血中使用重组活化因子VII的变化。

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BACKGROUND: Recombinant activated factor VII (rFVIIa) is being increasingly used as a treatment option in settings of uncontrolled bleeding. Despite this, national practice guidelines are lacking, resulting in widespread practice variation between providers. This investigation aimed to describe the differences in use of rFVIIa across Australian and New Zealand hospitals. METHODS: Data were extracted from the Haemostasis Registry that collects both contemporaneous and retrospective cases of off-licence (i.e. in non-haemophilia patients) rFVIIa use in participating institutions. Hospitals were classified according to geographical location and service provision. RESULTS: 2075 cases from 87 hospitals were recorded on the Haemostasis Registry. Across all hospital categories, over 41% of cases received rFVIIa in relation to cardiac surgery. Case complexity varied between providers, with large urban centres treating more severely ill patients. This was reflected in significant differences in the use of blood components and products before rFVIIa administration. Despite differences in patient complexity and use of blood products between hospital categories, response to treatment and patient outcomes remained similar across providers, with survival rates ranging from 68.29% to 70.41%. CONCLUSION: This is the largest study of off-licence use of rFVIIa. There is significant regional variation in the administration of rFVIIa in Australian and New Zealand hospitals, with little documentation of adherence to guidelines. National consensus guidelines based on available evidence should be developed and promulgated to ensure optimal outcomes.
机译：背景：重组活化因子VII（rFVIIa）越来越多地用作不受控制的出血的治疗选择。尽管如此，缺乏国家实践指南，导致提供商之间的实践差异很大。这项调查旨在描述澳大利亚和新西兰医院在使用rFVIIa方面的差异。方法：从止血登记处提取数据，该登记处收集了参与机构内同时使用和回顾性（即在非血友病患者中）rFVIIa使用情况的回顾性病例。根据地理位置和服务提供情况对医院进行分类。结果：止血登记处记录了来自87家医院的2075例病例。在所有医院类别中，超过41％的病例接受了与心脏手术有关的rFVIIa。提供者之间的病例复杂性各不相同，大型城市中心治疗的是重病患者​​。这反映在给予rFVIIa之前血液成分和产品使用上的显着差异。尽管各医院类别之间患者的复杂性和血液制品的使用存在差异，但各提供者对治疗和患者结局的反应仍然相似，生存率从68.29％到70.41％。结论：这是对rFVIIa的非许可使用的最大研究。在澳大利亚和新西兰的医院中，rFVIIa的管理存在明显的地区差异，几乎没有遵守指南的记录。应制定和颁布基于现有证据的国家共识指南，以确保获得最佳结果。

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