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美国成年人炎症性皮肤病与静脉血栓栓塞症的相关性。

Association of inflammatory skin diseases with venous thromboembolism in US adults.

机构信息

Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, USA.

Department of Dermatology, George Washington University School of Medicine and Health Sciences, Suite 2B-430, 2150 Pennsylvania Avenue NW, Washington, DC, 20037, USA.

出版信息

Arch Dermatol Res. 2021 May;313(4):281-289. doi: 10.1007/s00403-020-02099-6. Epub 2020 Jul 8.

Abstract

Patients with certain inflammatory skin diseases have multiple risk factors for venous thromboembolism (VTE). The objective of the study was to determine whether atopic dermatitis (AD), psoriasis, pemphigus, pemphigoid and/or hidradenitis is associated with VTE in US adults. Data were analyzed from the 2002-2012 Nationwide Inpatient Sample, a representative cohort of US hospitalizations (N = 72,512,581 adults, including 1,389,292 with VTE). In multivariable logistic regression models including age, sex, insurance, household income and race/ethnicity, hospitalization for AD (adjusted odds ratio [95% confidence intervals] 1.22 [1.17-1.27]), pemphigus (1.96 [1.68-2.28]) and pemphigoid (1.64 [1.47-1.83]) was associated with VTE. These associations remained significant in virtually all patient subsets, including males and females, different age groups and those with and without long-term corticosteroid use. In particular, AD, pemphigus and pemphigoid were each associated with DVT and PE. VTE was associated with increased inpatient length of stay, cost of care and mortality across all the inflammatory skin diseases. HS and psoriasis were not consistently associated with VTE. AD, pemphigus and pemphigoid and some subsets of patients with HS were associated with higher odds of hospitalization for VTE. Patients with these inflammatory skin diseases may benefit from increased screening and prevention of VTE.

摘要

患有某些炎症性皮肤病的患者存在静脉血栓栓塞症 (VTE) 的多种危险因素。本研究旨在确定特应性皮炎 (AD)、银屑病、天疱疮、类天疱疮和/或化脓性汗腺炎是否与美国成年人的 VTE 相关。数据分析来自于 2002 年至 2012 年全美住院患者样本,这是美国住院患者的代表性队列(N=72,512,581 名成年人,包括 1,389,292 名 VTE 患者)。在包含年龄、性别、保险、家庭收入和种族/民族的多变量逻辑回归模型中,AD(校正优势比 [95%置信区间] 1.22 [1.17-1.27])、天疱疮(1.96 [1.68-2.28])和类天疱疮(1.64 [1.47-1.83])住院与 VTE 相关。这些关联在几乎所有患者亚组中均具有统计学意义,包括男性和女性、不同年龄组以及使用和不使用长期皮质类固醇的患者。特别是,AD、天疱疮和类天疱疮均与 DVT 和 PE 相关。所有炎症性皮肤病患者的 VTE 均与住院时间延长、治疗费用增加和死亡率增加相关。HS 和银屑病与 VTE 无一致关联。AD、天疱疮和类天疱疮以及 HS 的某些亚组患者与 VTE 住院的可能性更高相关。患有这些炎症性皮肤病的患者可能受益于增加的 VTE 筛查和预防。

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