Sex as an Independent Risk Factor for Venous Thromboembolism in Sickle Cell Disease: A Cross-Sectional Study.
Sex as an Independent Risk Factor for Venous Thromboembolism in Sickle Cell Disease: A Cross-Sectional Study.
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性别作为镰状细胞病静脉血栓栓塞的独立危险因素：一项横断面研究。
DOI：
10.1089/jwh.2022.0046
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发表时间：
2022
期刊：
影响因子：
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通讯作者：
Sayani,FarzanaA
中科院分区：
文献类型：
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作者：
Roe,AndreaH;McAllister,Arden;Kete,Corinne;Pishko,Allyson;Whitworth,Hilary;Schreiber,CourtneyA;Sayani,FarzanaA
静脉血栓栓塞症(VTE)影响高达25%的镰状细胞病(SCD)患者，但危险因素尚未得到很好的描述。我们试图在我们的卫生系统中测量SCD患者中VTE的患病率，并描述病史、生物学性别和VTE之间的关系。我们对2014年6月至2019年6月期间前往宾夕法尼亚大学医学院血液学门诊的SCD患者进行了回顾性图表审查。对有和没有VTE病史的人的人口统计学和病史进行了比较。我们开发了一种Logistic回归模型来描述与VTE独立相关的因素。在确诊的597例SCD患者中，147例(24.6%)有静脉血栓栓塞史，其中女性100例，男性47例。在回归模型中，女性与静脉血栓栓塞史(优势比1.91，95%可信区间1.26-2.91)、肺动脉高压、羟基尿素使用和中风病史独立相关。仅在女性中，49.7%的人经产，18.8%的人使用过口服避孕药，这些比例在静脉血栓栓塞史上没有差异。在我们的卫生系统中，四分之一的SCD患者有静脉血栓栓塞史，证实了这一比例明显高于普通人群。与男性相比，女性患VTE的几率是男性的两倍，这突显了SCD疾病结局中的重要性别差异，并提出了对患有SCD的女性进行最佳怀孕和避孕护理的问题。
Venous thromboembolism (VTE) affects up to 25% of individuals with sickle cell disease (SCD), but risk factors are not well characterized. We sought to measure the prevalence of VTE among SCD patients in our health system and to describe the relationship between medical history, biological sex, and VTE. We performed a retrospective chart review of SCD patients who visited an outpatient hematology clinic within Penn Medicine between June 2014 and June 2019. Demographics and medical history were compared across those with and without a history of VTE. We developed a logistic regression model to describe factors independently associated with VTE. Of 597 patients with SCD who were identified, 147 (24.6%) had a history of VTE; 100 were female and 47 were male. In the regression model, female sex was independently associated with history of VTE (odds ratio 1.91, 95% confidence interval 1.26–2.91), as were pulmonary hypertension, hydroxyurea use, and history of stroke. Among females only, 49.7% were parous and 18.8% had used oral contraceptives, and these proportions did not differ by history of VTE. One-quarter of the SCD patients in our health system had a history of VTE, confirming significantly higher rates than in the general population. Females had twice the odds of VTE compared to males, highlighting an important sex disparity in SCD disease outcomes and raising questions regarding optimal pregnancy and contraceptive care for females with SCD.