Upper extremity deep vein thrombosis: A community-based perspective
Upper extremity deep vein thrombosis: A community-based perspective
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DOI：
10.1016/j.amjmed.2006.06.046
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发表时间：
2007-08-01
影响因子：
5.9
通讯作者：
Goldberg, Robert J.
中科院分区：
文献类型：
--
作者：
Spencer, Frederick A.;Emery, Cathy;Goldberg, Robert J.
方法：对1999年马萨诸塞州伍斯特市(2000年人口普查=478,000人)的所有居民(2000年人口普查=478,000人)的临床资料进行回顾和验证。结果：上肢深静脉血栓的年龄调整发病率(每10万人)为16(95%可信区间，13-20)，与91(95%可信区间，13-20)比较，差异有统计学意义。83-100)，用于下肢深静脉血栓形成。与下肢深静脉血栓形成患者相比，上肢深静脉血栓形成患者更有可能接受最近的中心线放置、心脏手术或重症监护病房入院。尽管上肢深静脉血栓形成患者的短期和1年复发率和全因死亡率在上肢深静脉血栓形成患者和下肢深静脉血栓形成患者之间没有显著差异，但上肢深静脉血栓形成患者在发病或随访时发生肺血栓的可能性较小。结论：上肢深静脉血栓形成患者是社区中临床上重要的患者群体。与上肢深静脉血栓形成患者相比，上肢深静脉血栓形成患者的危险因素、肺栓塞的发生情况以及静脉血栓栓塞症复发的时间和位置不同。这些数据表明，预防和治疗上肢深静脉血栓形成的策略需要进一步研究和完善。(C)2007 Elsevier Inc.保留所有权利。
PURPOSE: The purpose of this study was to examine the magnitude, risk factors, management strategies, and outcomes in a population-based investigation of patients with upper, as compared with lower, extremity deep vein thrombosis diagnosed in 1999.METHODS: The medical records of all residents from Worcester, Massachusetts (2000 census = 478,000) diagnosed with ICD-9 codes consistent with possible deep vein thrombosis at all Worcester hospitals during 1999 were reviewed and validated.RESULTS: The age-adjusted attack rate (per 100,000 population) of upper extremity deep vein thrombosis was 16 (95% confidence interval [CI], 13-20) compared with 91 (95% CI, 83-100) for lower extremity deep vein thrombosis. Patients with upper extremity deep vein thrombosis were significantly more likely to have undergone recent central line placement, a cardiac procedure, or an intensive care unit admission than patients with lower extremity deep vein thrombosis. Although short-term and 1-year recurrence rates of venous thromboembolism and all-cause mortality were not significantly different between patients with upper, versus lower, extremity deep vein thrombosis, patients with upper extremity deep vein thrombosis were less likely to have pulmonary embolism at presentation or in follow-up.CONCLUSIONS: Patients with upper extremity deep vein thrombosis represent a clinically important patient population in the community setting. Risk factors, occurrence of pulmonary embolism, and timing and location of venous thromboembolism recurrence differ between patients with upper as compared with lower extremity deep vein thrombosis. These data suggest that strategies for prophylaxis and treatment of upper extremity deep vein thrombosis need further study and refinement. (c) 2007 Elsevier Inc. All rights reserved.