静脉血栓栓塞风险在肌缩侧面硬化症:一个医院记录链接研究研究
Raph Goldacre1, Michael Trubshaw2, Eva J A Morris1
1Big Data Institute, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
Journal of neurology, neurosurgery, and psychiatry
|March 28, 2024
概括
肌缩侧面硬化症 (ALS) 患者的静脉血栓塞栓症 (VTE) 风险明显更高. 这种风险在年轻的ALS患者中特别高,因此需要重新评估预防策略.
科学领域:
- 神经学 神经学
- 血管医学 血管医学
- 流行病学 流行病学
背景情况:
- 静脉血栓塞栓症 (VTE) 是已知的肌缩侧面硬化症 (ALS) 的并发症.
- 肺栓塞 (PE) 有助于ALS患者的一个子集的死亡率.
- 为了平衡VTE预防的好处与风险,需要准确的ALS发病率数据.
研究的目的:
- 为了确定诊断为ALS的患者中VTE的发生率.
- 为了比较ALS患者与对照人群的VTE风险.
- 调查ALS患者中VTE风险的年龄相关差异.
主要方法:
- 使用英格兰医院情节统计数据库 (2003-2019) 进行的回顾性队列研究.
- 包括21,163名ALS患者和17,425,337名对照患者.
- 长达2年的随访,计算VTE的调整危险比率 (aHRs).
主要成果:
- 在ALS队列中,静脉动脉瘤的发病率为每1000人/年18.8.
- 与对照组相比,患有ALS的患者的VTE相对风险是2.7倍以上 (aHR 2.7).
- 年轻的ALS患者 (65岁以下) 的VTE风险明显高 (aHR为5.34),高于老年患者 (aHR为1.86).
结论:
- 患有ALS的患者面临着明显增加的静脉瘤风险,与其他不运动的神经疾病相比.
- 年轻ALS患者的风险增加表明需要有针对性的VTE评估.
- 建议进行随机对照试验,以评估ALS患者的常规抗血栓治疗.
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