Corinne Goldsmith Dickinson Center for Multiple Sclerosis, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Mult Scler. 2017 Jun;23(7):988-994. doi: 10.1177/1352458516670736. Epub 2016 Sep 26.
Neuromyelitis optica spectrum disorder (NMOSD) patients may be at increased risk of venous thromboembolism (VTE) not only due to ambulatory disability but also due to systemic autoimmune and inflammatory mechanisms altering the hemostatic balance.
To compare the risk of VTE in NMOSD versus multiple sclerosis (MS) patients hospitalized for acute relapses.
Hospital admissions for MS or NMOSD exacerbations were retrospectively identified. Demographics and medical history were recorded. The relationship between visit diagnosis and presence of VTE within 6 weeks of relapse onset was assessed by univariate logistic regression. A multivariate model evaluated the relationship between diagnosis, age, race, gender, body mass index (BMI), disease modifying therapy use, oral corticosteroid use, oral contraceptive use, smoking, length of stay (LOS), and ambulatory status on VTE risk.
A total of 30 NMOSD patients had 55 hospitalizations; 179 MS patients had 264 hospitalizations. Six NMOSD patients and one MS patient had VTE. NMOSD visits compared to MS visits had an odds ratio (OR) of VTE of 32.2 ( p = 0.002). NMOSD was more likely to be associated with VTE (OR = 17.4; p = 0.01) controlling for age, LOS, and ambulatory disability.
NMOSD may be a risk factor for VTE. Larger prospective studies are required to confirm this risk and determine implications for prophylaxis.
神经免疫性视神经脊髓炎谱系疾病（NMOSD）患者不仅因行动不便而静脉血栓栓塞（VTE）风险增加，而且还存在全身性自身免疫和炎症机制改变止血平衡。
比较 NMOSD 与多发性硬化症（MS）患者因急性复发住院时 VTE 的风险。
回顾性确定 MS 或 NMOSD 加重的住院病例。记录人口统计学和病史。通过单变量逻辑回归评估就诊诊断与复发发作后 6 周内 VTE 之间的关系。多变量模型评估诊断、年龄、种族、性别、体重指数（BMI）、疾病修正治疗使用、口服皮质类固醇使用、口服避孕药使用、吸烟、住院时间（LOS）、以及行动能力与 VTE 风险之间的关系。
共 30 例 NMOSD 患者有 55 次住院，179 例 MS 患者有 264 次住院。6 例 NMOSD 患者和 1 例 MS 患者有 VTE。与 MS 就诊相比，NMOSD 就诊的 VTE 比值比（OR）为 32.2（p=0.002）。在控制年龄、LOS 和行动能力障碍后，NMOSD 更可能与 VTE 相关（OR=17.4；p=0.01）。
NMOSD 可能是 VTE 的危险因素。需要更大的前瞻性研究来证实这一风险，并确定预防的意义。
