Department of Medicine, Guthrie Robert Packer Hospital, Sayre, PA, USA.
Health Administration, Rutgers University, New Brunswick, NJ, USA.
Postgrad Med. 2021 Mar;133(2):160-165. doi: 10.1080/00325481.2020.1863717. Epub 2020 Dec 31.
: Venous thromboembolism (VTE) occurs frequently in acute myeloid leukemia (AML) patients. There are no population-based studies from the United States (U.S.) analyzing this association. The study aims to analyze the trends, predictors of mortality, and outcomes of VTE in AML patients.: We analyzed the publicly available Nationwide Inpatient Sample (NIS) for years 2010-2014. Hospitalizations due to AML were identified by previously validated International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) codes as the primary diagnosis. VTE was identified by ICD-9-CM codes as secondary diagnosis. Hospitalizations with age less than 18 years of age were excluded. The trends and outcomes were determined using Chi-squared (χ2) test and multivariate regression models.: From 2010 to 2014, there were 313,282 hospitalizations with a primary diagnosis of AML and 1,633 hospitalizations (0.1%) had VTE as a concurrent diagnosis. There was a significant increase in the proportion of AML hospitalizations with VTE from 0.47% in 2010 to 0.56% in 2014 (P = 0.014). Multivariable regression analysis showed that the odds of in-hospital mortality were not higher in AML hospitalizations with VTE (odds ratio [OR] 1.11; 95% confidence interval [CI] 0.81-1.52; P = 0.5) than those without VTE. Age group above 84 years carried the highest risk of mortality (OR 3.20; 95% CI 2.77-3.70; P < 0.0001) in AML-VTE patients. Black (OR 1.23; 95% CI 1.13-1.35; P < 0.0001) and uninsured patients (OR 1.50; 95% CI 1.31-1.73; P < 0.0001) were at significantly higher odds of in-hospital mortality amongst the AML-VTE hospitalizations.: The proportion of AML hospitalizations with VTE continues to rise in the U.S. After adjusting for confounders, increasing age, Black race, and lack of insurance were found to have higher risk of in-hospital mortality in the AML-VTE cohort. The odds of in-hospital mortality in AML hospitalizations with VTE are not higher than those without VTE.
静脉血栓栓塞症（VTE）在急性髓系白血病（AML）患者中很常见。目前还没有来自美国（U.S.）的基于人群的研究分析这种关联。本研究旨在分析 AML 患者中 VTE 的趋势、死亡率预测因素和结局。
我们分析了 2010 年至 2014 年期间公开的全美住院患者样本（NIS）。AML 住院患者通过先前验证的国际疾病分类，第 9 版，临床修订版（ICD-9-CM）代码作为主要诊断确定。VTE 通过 ICD-9-CM 代码作为次要诊断确定。排除年龄小于 18 岁的住院患者。使用卡方（χ2）检验和多变量回归模型确定趋势和结局。
2010 年至 2014 年，有 313282 例 AML 住院患者的主要诊断为 AML，其中 1633 例（0.1%）同时诊断为 VTE。同时患有 VTE 的 AML 住院患者比例从 2010 年的 0.47%显著增加到 2014 年的 0.56%（P=0.014）。多变量回归分析显示，同时患有 VTE 的 AML 住院患者的院内死亡率并不高于没有 VTE 的患者（比值比[OR]1.11；95%置信区间[CI]0.81-1.52；P=0.5）。84 岁以上年龄组的 AML-VTE 患者的死亡率风险最高（OR 3.20；95%CI 2.77-3.70；P<0.0001）。黑人（OR 1.23；95%CI 1.13-1.35；P<0.0001）和没有保险的患者（OR 1.50；95%CI 1.31-1.73；P<0.0001）在 AML-VTE 住院患者中，院内死亡率的可能性显著更高。
在美国，同时患有 VTE 的 AML 住院患者的比例继续上升。在调整混杂因素后，发现年龄增长、黑人种族和缺乏保险与 AML-VTE 队列中的院内死亡风险增加有关。同时患有 VTE 的 AML 住院患者的院内死亡率并不高于没有 VTE 的患者。
