Reduced Physical Activity Levels in Children after a First Episode of Acute Venous Thromboembolism.
Reduced Physical Activity Levels in Children after a First Episode of Acute Venous Thromboembolism.
复制标题
首次急性静脉血栓栓塞发作后儿童体力活动水平降低。
DOI：
10.1016/j.jpeds.2019.12.062
复制
发表时间：
2020
期刊：
影响因子：
--
通讯作者：
Babb,Tony
中科院分区：
文献类型：
--
作者：
Zia,Ayesha;Yang,Zhuo;Zhang,Song;Babb,Tony
目的评估急性静脉血栓栓塞（VTE）后儿童的体力活动，研究体力活动减少的预测因素及其与血栓后综合征的关系。研究设计采用病例对照研究设计，我们纳入了44例急性VTE儿童，并使用Godin-Shephard休闲时间体力活动问卷和健康-诊断后3个月和6个月的相关生活质量，相对于44名年龄和性别匹配的对照组。我们使用Manco-Johnson仪器评估血栓后综合征评分，以测量归因于DVT后遗症的症状和体征。结果VTE病例的体力活动在诊断后3个月减少（36.6 ± 29.0 vs 56.8 ± 25.0;P= .002），但与对照组相比，6个月时差异消失（57.5 ± 39.0 vs 56.8 ± 25.0;P= .60）。在诊断后3个月和6个月，总体而言，70%和50%的VTE病例低于其VTE前的体力活动水平;大多数提供者没有解决体力活动问题。在多变量分析中，诊断时完全静脉闭塞性血栓形成病例的体力活动降低32分，诊断为肺栓塞相对于DVT降低11分，健康相关生活质量评分每增加1个单位，体力活动增加0.72分。在诊断后3个月的体力活动并没有预测血栓后syndrome.ConclusionsVTE的短期风险限制在第一个3个月的急性事件后，在儿童的体力活动，但差异是不存在的6个月。只有50%的静脉血栓栓塞幸存者在诊断后6个月内恢复了静脉血栓栓塞前的身体活动水平。
ObjectiveTo assess physical activity in children following acute venous thromboembolism (VTE), examine predictors of reduced physical activity and its relationship to post-thrombotic syndrome.Study designUsing a case-control study design, we enrolled 44 children with acute VTE, and compared physical activity using the Godin-Shephard Leisure-Time Physical Activity Questionnaire and health-related quality of life at 3 and 6 months after diagnosis relative to 44 age- and sex-matched controls. We assessed post-thrombotic syndrome scores using the Manco-Johnson Instrument to measure symptoms and signs attributed to sequelae of DVT in cases.ResultsThe physical activity of VTE cases was decreased at 3 months after diagnosis (36.6 ± 29.0 vs 56.8 ± 25.0;P= .002), but the differences disappeared at 6 months (57.5 ± 39.0 vs 56.8 ± 25.0;P= .60) relative to controls. At 3 and 6 months after diagnosis, overall, 70% and 50% of VTE cases were below their pre-VTE physical activity levels; providers did not address physical activity in the majority. In multivariable analysis, physical activity of cases was lower by 32 points for completely veno-occlusive thrombosis at diagnosis, 11 points for a diagnosis of pulmonary embolism relative to DVT, and increased by 0.72 points for every unit increase in health-related quality of life score. Physical activity at 3 months after diagnosis did not predict the short-term risk of post-thrombotic syndrome.ConclusionsVTE limits physical activity in children in the first 3 months after the acute event, but the differences were nonexistent at 6 months. Only 50 percent of VTE survivors resume their pre-VTE physical activity levels within 6 months after diagnosis.