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血液性恶性瘤的危急病成人患者的静脉血栓栓塞:基于人口的队列研究

Federico C Carini^1,2,3,4, Federico Angriman^5,6,7, Damon C Scales^5,7,8

¹Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada. federico.carini@uhn.ca.

Intensive care medicine

|January 3, 2024

概括

患有血液性恶性瘤的住院患者面临更高的静脉血栓塞栓症 (VTE) 风险,特别是那些在重症监护室 (ICU) 的患者. 危急疾病和特定的患者因素显著增加了静脉瘤发病率.

科学领域:

血液学血液学血液学
在瘤学瘤学.
临界护理医学临界护理医学
流行病学流行病学

背景情况:

静脉血栓塞栓症 (VTE) 是患有血液性恶性瘤的患者的严重并发症.
在这种人群中了解VTE和大出血的风险因素对于临床管理至关重要.

研究的目的:

为了确定血液性恶性瘤住院患者的静脉动脉瘤和大出血的发生率.
在这个患者群体中评估严重疾病和静脉瘤之间的关联.
为了确定与VTE风险相关的基线特征.

主要方法:

基于人口的队列研究在加拿大安大略省 (2006-2017年).
包括新诊断为血液性恶性瘤的成年患者.
主要结局:VTE (肺栓塞或深静脉血栓). 二次结果:严重出血和住院死亡率.
在重症监护室 (ICU) 和非ICU患者之间比较VTE发病率.

主要成果:

总共有76,803名患者被纳入;20,524人至少有一次入住了ICU.
在ICU患者中,VTE发生率为3.7%,非ICU患者为1.2%.
重度出血发生率在ICU患者中为7.6%,而非ICU患者中为2.4% (OR 3.33).
危急疾病仍然是静脉瘤的重要预测因素 (aOR 2.92).
在患有先前VTE (OR 6.64) 和特定血液性恶性亚型的患者中观察到更高的VTE风险.
较低的VTE风险与诊断后1年 (OR 0.64) 和低血小板计数 (OR 0.63) 的入院相关.

结论:

危急性疾病与住院的血液性恶性瘤患者的静脉瘤发病率增加密切相关.
特定的基线特征,包括先前的VTE和诊断后的时间,影响VTE风险.
这些发现强调了在这个脆弱人群中需要有针对性的VTE预防和管理策略.

关键词:

流血出血流血出血这是一个DVT,DVT.血液的恶性瘤.在重症监护病房的重症监护病房.这是一个VTE,VTE是VTE.

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