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日本伴有或不伴有恶性肿瘤的深静脉血栓形成患者的流行病学和预后数据。

Epidemiological and outcome data in Japanese patients with deep vein thrombosis with and without malignancy.

作者信息

Yokoi Kensuke, Hara Masahiko, Ueda Yasunori, Yamamoto Keiichi, Ota Keiko, Kabata Daijiro, Kitamura Tetsuhisa, Sakata Yasushi, Shintani Ayumi

机构信息

Cardiovascular Division, Osaka National Hospital, Osaka, Japan.

Department of Clinical Epidemiology and Biostatistics, Osaka University Graduate School of Medicine, Center of Medical Innovation and Translational Research 603A, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.

出版信息

Heart Vessels. 2017 Dec;32(12):1469-1477. doi: 10.1007/s00380-017-1025-0. Epub 2017 Jul 24.

Abstract

There are very few epidemiological studies on Japanese patients with deep vein thrombosis (DVT). In particular, mortality rate differences in Japanese DVT patients with and without malignancy have rarely been evaluated. To elucidate these differences, we enrolled 211 patients who had been diagnosed with de-novo acute DVT of the pelvis or lower extremities between January 2012 and December 2015. The clinical characteristics, treatment information, and follow-up data were retrospectively assessed. We compared these variables in patients with (n = 120) and without (n = 91) concomitant malignancies. The median age of patients was 67 years, 33.7% were male, and 82.9% patients were treated with oral anticoagulants including direct oral anticoagulants. The clinical characteristics and treatment provided were almost identical in the two groups with some exceptions. Three-year survival rates of the total population, patients with malignancy, and patients without malignancy were 80.6, 67.6, and 97.6%, respectively (log-rank p < 0.001). Multivariable Cox regression analysis demonstrated that malignancy was independently associated with high risk of 3-year all-cause mortality with an adjusted hazard ratio of 9.1 (95% confidence interval; 2.1-39.0, p = 0.003). Bootstrap validation demonstrated an acceptable index corrected slope of 0.766 without significant overfitting in a multivariable model. In conclusion, we analyzed epidemiological data on Japanese patients with DVT. Malignancy was independently associated with increased 3-year all-cause mortality.

摘要

针对日本深静脉血栓形成(DVT)患者的流行病学研究非常少。特别是,很少评估合并恶性肿瘤和未合并恶性肿瘤的日本DVT患者的死亡率差异。为了阐明这些差异,我们纳入了2012年1月至2015年12月期间被诊断为新发骨盆或下肢急性DVT的211例患者。对临床特征、治疗信息和随访数据进行了回顾性评估。我们比较了合并(n = 120)和未合并(n = 91)恶性肿瘤患者的这些变量。患者的中位年龄为67岁,33.7%为男性,82.9%的患者接受了包括直接口服抗凝剂在内的口服抗凝治疗。两组的临床特征和治疗情况几乎相同,但有一些例外。总体人群、合并恶性肿瘤患者和未合并恶性肿瘤患者的三年生存率分别为80.6%、67.6%和97.6%(对数秩检验p < 0.001)。多变量Cox回归分析表明,恶性肿瘤与三年全因死亡率高风险独立相关,调整后的风险比为9.1(95%置信区间:2.1 - 39.0,p = 0.003)。自举验证表明,在多变量模型中,校正斜率的可接受指数为0.766,无明显过度拟合。总之,我们分析了日本DVT患者的流行病学数据。恶性肿瘤与三年全因死亡率增加独立相关。

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