第一次静脉血栓塞栓症后的死亡原因
Frida Lonnberg1,2, Andreas Roos1,2, Maria Farm3,4
1Department of Medicine, Karolinska Institute, Solna, Sweden.
Thrombosis journal
|February 2, 2024
概括
在急诊室诊断为静脉血栓塞栓症 (VTE) 的患者面临死亡风险显著增加. 这包括增加全因死亡,癌症相关死亡和心血管事件的风险,特别是肺栓塞 (PE).
科学领域:
- 心血管医学 心血管医学
- 紧急医疗 紧急医疗
- 血栓形成研究研究
背景情况:
- 社区获得的静脉血栓塞栓症 (VTE) 是在急诊室 (ED) 诊断的重大健康问题.
- 在初始VTE诊断后了解死亡原因对于患者的治疗结果至关重要.
研究的目的:
- 调查在ED环境中诊断出他们第一次社区获得的VTE的未经选择的患者的死亡原因.
- 为了比较VTE患者和一般患者群体之间的死亡风险.
主要方法:
- 一项队列研究包括18岁以上的患者,他们在2016-2017年期间访问了斯德哥尔摩县的5个ED.
- 确定了首次诊断为深静脉血栓症 (DVT) 或肺栓塞 (PE) 的患者.
- 考克斯回归模型分析了全因和因特定死亡率,计算了危险比率 (HR) 和95%置信区间 (CI).
主要成果:
- 在359,884次急救诊所中,2.1%的人被诊断为VTE (4,384个DVT,3,212个PE).
- 静脉瘤患者年龄较大;21%的患者在2.1年的随访期间死亡,而参考组的6.7%.
- 任何原因的死亡风险几乎是DVT的两倍 (HR 1.7) 和PE的三倍多 (HR 3.4).
- 与癌症相关的死亡风险在DVT中增加了3倍,在PE中增加了5倍.
- 预发性乳腺炎的诊断与心血管死亡风险增加2.2倍有关.
结论:
- 在ED诊断出VTE的患者表现出高于所有原因死亡的风险.
- 风险扩展到特定原因,包括心血管死亡,突显了VTE的严重程度.
- 肺栓塞 (PE) 与特别高的死亡风险有关,包括心血管原因.
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