Venous thromboembolism in patients with diabetes mellitus.
Venous thromboembolism in patients with diabetes mellitus.
复制标题
糖尿病患者的静脉血栓栓塞。
DOI：
10.1016/j.amjmed.2011.12.004
复制
发表时间：
2012-07
影响因子：
5.9
通讯作者：
Spencer, Frederick A.
中科院分区：
文献类型：
--
作者：
Piazza, Gregory;Goldhaber, Samuel Z.;Kroll, Aimee;Goldberg, Robert J.;Emery, Catherine;Spencer, Frederick A.
关键词：
大多数流行病学研究表明，糖尿病患者发生静脉血栓栓塞的风险增加。我们的目的是比较既往诊断为糖尿病和非糖尿病患者静脉血栓栓塞的临床特征、预防、治疗和结局。我们在基于人群的伍斯特静脉血栓栓塞研究中研究了2488例经证实的静脉血栓栓塞的糖尿病患者。在2488例静脉血栓栓塞患者中，476例（19.1%）有糖尿病临床病史。超过三分之一的糖尿病患者因非静脉血栓栓塞相关疾病住院或在诊断前3个月内接受过大手术，但未进行血栓预防。糖尿病患者比非糖尿病患者更可能在静脉血栓栓塞后出现复杂的病程。糖尿病患者比非糖尿病患者更容易发生复发性深静脉血栓形成（14.9% vs 10.7%）和长期大出血并发症（16.4% vs 11.7%）（均P = 0.01）。糖尿病与复发性深静脉血栓形成风险显著增加相关（校正比值比[AOR] 1.74; 95%置信区间[CI]，1.21-2.51）。出院时阿司匹林治疗（AOR 1.59; 95% CI，1.1-2.3）和慢性肾脏疾病（AOR 2.19; 95% CI，1.44-3.35）是长期大出血的独立预测因子。发生静脉血栓栓塞的糖尿病患者更可能出现复杂的临床病程。糖尿病是复发性深静脉血栓形成的独立预测因子。我们观察到糖尿病患者的血栓预防率较低。进一步的研究应集中在静脉血栓栓塞预防在这个脆弱的人群。
The majority of epidemiological studies demonstrate an increased risk of venous thromboembolism among diabetic patients. Our aim was to compare clinical characteristics, prophylaxis, treatment, and outcomes of venous thromboembolism in patients with and without previously diagnosed diabetes. We studied diabetic patients in the population-based Worcester Venous Thromboembolism Study of 2488 consecutive patients with validated venous thromboembolism. Of 2488 venous thromboembolism patients, 476 (19.1%) had a clinical history of diabetes. Thromboprophylaxis was omitted in more than one third of diabetic patients who had been hospitalized for non-venous-thromboembolism-related illness or had undergone major surgery within 3 months before diagnosis. Patients with diabetes were more likely than nondiabetic patients to have a complicated course after venous thromboembolism. Patients with diabetes were more likely than patients without diabetes to suffer recurrent deep vein thrombosis (14.9% vs 10.7%) and long-term major bleeding complications (16.4% vs 11.7%) (all P = .01). Diabetes was associated with a significant increase in the risk of recurrent deep vein thrombosis (adjusted odds ratio [AOR] 1.74; 95% confidence interval [CI], 1.21–2.51). Aspirin therapy at discharge (AOR 1.59; 95% CI, 1.1–2.3) and chronic kidney disease (AOR 2.19; 95% CI, 1.44–3.35) were independent predictors of long-term major bleeding. Patients with diabetes who developed venous thromboembolism were more likely to suffer a complicated clinical course. Diabetes was an independent predictor of recurrent deep vein thrombosis. We observed a low rate of thromboprophylaxis in diabetic patients. Further studies should focus on venous thromboembolism prevention in this vulnerable population.
登录
查看更多内容
影响因子：
5.9
作者：
Spencer, Frederick A.;Emery, Cathy;Goldberg, Robert J.
通讯作者：
Goldberg, Robert J.
影响因子：
10.4
作者：
Amin, A.;Stemkowski, S.;Yang, G.
通讯作者：
Yang, G.
影响因子：
3.1
作者：
Stein, Paul D.;Goldman, Jose;Yaekoub, Abdo Y.
通讯作者：
Yaekoub, Abdo Y.
影响因子：
4
作者：
Shetty, Ranjith;Seddighzadeh, Ali;Goldhaber, Samuel Z.
通讯作者：
Goldhaber, Samuel Z.
影响因子：
9.6
作者：
Tapson, Victor F.;Decousus, Herve;Anderson, Frederick A.
通讯作者：
Anderson, Frederick A.