Chronic obstructive pulmonary disease and deep vein thrombosis: a prevalent combination
Chronic obstructive pulmonary disease and deep vein thrombosis: a prevalent combination
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DOI：
10.1007/s11239-007-0157-y
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发表时间：
2008-08-01
影响因子：
4
通讯作者：
Goldhaber, Samuel Z.
中科院分区：
文献类型：
--
作者：
Shetty, Ranjith;Seddighzadeh, Ali;Goldhaber, Samuel Z.
慢性阻塞性肺疾病（COPD）患者发生静脉血栓栓塞（VTE）的风险增加。我们分析了一个大型的美国深静脉血栓形成（DVT）登记研究，以探讨COPD和VTE患者的概况。方法将668例（12%）COPD患者的人口统计学资料、症状、危险因素、预防和初始管理与来自美国183家机构的5，451例超声证实DVT的前瞻性登记研究中的3，907例非COPD患者进行比较。结果COPD合并DVT患者年龄大（中位数72.5岁比68.0岁，P < 0.0001），男性多（52.3%比44.8%，P = 0.0004）。在诊断DVT时住院患者的比例更高（62.0% vs.51.9%，P < 0.0001）。COPD患者更有可能入住重症监护室（ICU）（27.7% vs.19.8%，P = 0.0003），更有可能需要机械通气（23.2% vs. 13.6%，P < 0.0001），更有可能接受下腔静脉（IVC）滤器（19.1% vs. 15.1%，P = 0.009）。COPD患者更常合并肺栓塞（PE）（22.8% vs.17.8%，P = 0.005）以及合并充血性心力衰竭（29.5% vs.12.5%，P < 0.0001）。结论合并COPD的DVT患者较其他DVT患者具有更高的医疗紧急度。这导致更频繁的IVC过滤器插入。
Background Patients with chronic obstructive pulmonary disease (COPD) are at increased risk for venous thromboembolism (VTE). We analyzed a large US deep vein thrombosis (DVT) registry to explore the profile of patients with COPD and VTE. Methods Demographics, symptoms, risk factors, prophylaxis, and initial management of 668 (12%) patients with COPD were compared to 3,907 patients without COPD from a prospective registry of 5,451 consecutive patients with ultrasound-confirmed DVT at 183 institutions in the United States. Results COPD patients with DVT were older (median 72.5 years vs. 68.0 years, P < 0.0001) and more likely to be male (52.3% vs. 44.8%, P = 0.0004). They were more likely to be inpatients at the time of diagnosis of DVT (62.0% vs. 51.9%, P < 0.0001). COPD patients were more likely to be admitted to the Intensive Care Unit (ICU) (27.7% vs.19.8%, P = 0.0003), more likely to require mechanical ventilation (23.2% vs. 13.6%, P < 0.0001), and more likely to receive inferior vena caval (IVC) filters (19.1% vs. 15.1%, P = 0.009). COPD patients more often had concomitant pulmonary embolism (PE) (22.8% vs.17.8%, P = 0.005) as well as concomitant congestive heart failure (29.5% vs. 12.5%, P < 0.0001). Conclusions DVT patients with COPD have a greater medical acuity than other DVT patients. This results in more frequent IVC filter insertion.