Department of Cardio-Thoracic Surgery, Tays Heart Hospital, Tampere University Hospital, Ensitie 4, 33520, Tampere, Finland.
Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, P.O. Box 2000, 33521, Tampere, Finland.
Lung. 2020 Aug;198(4):671-678. doi: 10.1007/s00408-020-00374-x. Epub 2020 Jun 30.
Pleural infections are associated with significant inflammation, long hospitalizations, frequent comorbidities, and are often treated operatively-all of which are consequential risk factors for thrombo-embolic complications. However, their occurrence following the treatment of pleural infection is still unknown. The aim of the study was to ascertain the early and long-term occurrence of thrombo-embolic events in patients treated for pleural infections.
The study included all patients that were treated for pleural infections in Tampere University Hospital between January 2000 and December 2016. Data regarding later treatment episodes due to pulmonary embolisms and/or deep vein thromboses as well as survival data were requested from national registries. The rates were also compared to a demographically matched reference population adjusted for age, sex, and the location of residence.
The final study population comprised 536 patients and 5318 controls (median age 60, 78% men). The most common etiology for pleural infection was pneumonia (73%) and 85% underwent surgical treatment for pleural infection. The occurrence of thrombo-embolic complications in patients and controls was 3.8% vs 0.1% at three months, 5.0% vs 0.4% at one year, 8.8% vs 1.0% at three years, and 12.4% vs 1.8% at five years, respectively, p < 0.001 each. Female sex, advanced age, chronic lung disease, immunosuppression, video-assisted surgery, and non-pneumonic etiology were associated with a higher incidence of thrombo-embolism.
The occurrence of thrombo-embolic events-particularly pulmonary embolism but also deep vein thrombosis-was significant in patients treated for pleural infections, both initially and during long-term follow-up.
胸膜感染与显著的炎症、住院时间长、经常合并疾病有关，且通常需要手术治疗——所有这些都是血栓栓塞并发症的重要危险因素。然而，胸膜感染治疗后发生这些并发症的情况仍不清楚。本研究旨在确定胸膜感染患者治疗后早期和长期发生血栓栓塞事件的情况。
本研究纳入了 2000 年 1 月至 2016 年 12 月期间在坦佩雷大学医院接受胸膜感染治疗的所有患者。从国家登记处请求了有关因肺栓塞和/或深静脉血栓形成而进行后续治疗以及生存数据的信息。还将这些比率与按年龄、性别和居住地进行匹配的参考人群进行了比较。
最终的研究人群包括 536 名患者和 5318 名对照者（中位年龄 60 岁，78%为男性）。胸膜感染最常见的病因是肺炎（73%），85%的患者因胸膜感染接受了手术治疗。患者和对照者在三个月时血栓栓塞并发症的发生率分别为 3.8%和 0.1%，在一年时分别为 5.0%和 0.4%，在三年时分别为 8.8%和 1.0%，在五年时分别为 12.4%和 1.8%，p 值均<0.001。女性、高龄、慢性肺部疾病、免疫抑制、电视辅助手术和非肺炎病因与更高的血栓栓塞发生率相关。
胸膜感染患者在治疗后，无论是在初始治疗期间还是在长期随访期间，发生血栓栓塞事件（尤其是肺栓塞，但也包括深静脉血栓形成）的情况显著。
