Risk factors associated with symptomatic pulmonary embolism in a large cohort of deep vein thrombosis patients
Risk factors associated with symptomatic pulmonary embolism in a large cohort of deep vein thrombosis patients
复制标题
DOI：
10.1160/th04-09-0587
复制
发表时间：
2005-03-01
影响因子：
6.7
通讯作者：
Goldhaber, SZ
中科院分区：
文献类型：
--
作者：
Kucher, N;Tapson, VF;Goldhaber, SZ
在深静脉血栓形成（DVT）患者中，导致伴随症状性肺栓塞（PE）的因素仍然不确定。从一个由5，451例超声证实DVT的连续患者组成的前瞻性队列中，我们分析了4，211例已知存在（n = 639）或不存在（n = 3572）症状性PE的患者。DVT + PE（63.7 ± 15.6岁; 49%男性）和DVT患者（63.4 ± 17.3岁; 46%男性）的年龄和性别相似。DVT合并PE患者的体重指数（BMI）（中位数29.0，范围15.4-67.0 kg/m2）高于DVT患者（中位数26.8，范围9.7-64.4 kg/m2; p < 0.001）。慢性肺部疾病（17% vs. 12%; p < 0.001）、PE个人史（11% vs. 6%; p < 0.001）和DVT或PE家族史（8% vs. 4%; p < 0.001）在DVT合并PE患者中更常见。27%的DVT合并PE患者在血栓栓塞事件发生前接受了预防治疗，而DVT患者为32%（p=0.002）。近端DVT（OR 1.84，95% CI 1.39-2.43），既往PE（OR 1.68，95%CI 1.20-2.35），肥胖（BMI > 30 kg/m（2））（OR 1.65，95% CI 1.33-2.04），慢性肺病（OR 1.51，95%CI 1.13-2.01）以及预防性治疗遗漏（OR 1.30，95%CI 1.04-1.64）是伴随症状性PE的独立预测因素。
In patients with deep vein thrombosis (DVT), the factors which predispose to concomitant symptomatic pulmonary embolism (PE) have remained uncertain. From a prospective cohort of 5,451 consecutive patients with ultrasound-confirmed DVT we analyzed 4,211 patients with a known status for presence (n = 639) or absence (n = 3572) of symptomatic PE. Age and gender were similar in DVT plus PE (63.7 +/- 15.6 years; 49% men) and DVT patients (63.4 +/- 17.3 years; 46% men). Body mass index (BMI) was higher in patients with DVT plus PE (median 29.0, range 15.4-67.0 kg/m(2)) than in patients with DVT (median 26.8, range 9.7-64.4 kg/m(2); p < 0.001). Chronic lung disease (17% vs. 12%; p < 0.001), a personal history of PE (11% vs. 6%; p < 0.001), and a family history of DVT or PE (8% vs. 4%; p < 0.001) were more frequent in DVT plus PE patients. Twenty-seven percent of DVT plus PE patients received prophylaxis prior to the thromboembolic event compared with 32% of DVT patients (p=0.002). Proximal DVT (OR 1.84,95% CI 1.39-2.43), prior PE (OR 1.68,95% CI 1.20-2.35), obesity (BMI > 30 kg/m(2)) (OR 1.65, 95% CI 1.33-2.04), chronic lung disease (OR 1.51, 95% CI 1.13-2.01), as well as omission of prophylaxis (OR 1.30,95% CI 1.04-1.64) emerged as independent predictors of concomitant symptomatic PE.