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马德里地区住院COVID-19患者静脉血栓栓塞的发病率及临床特征

Incidence and clinical profile of venous thromboembolism in hospitalized COVID-19 patients from Madrid region.

作者信息

Arribalzaga Karmele, Martínez-Alfonzo Inés, Díaz-Aizpún Carola, Gutiérrez-Jomarrón Isabel, Rodríguez Mario, Castro Quismondo Nerea, Pérez-Fernández Elia, Velasco-Rodríguez Diego, Gómez Elvira, Fernández Begoña, Vilches Alba, Martín-Herrero Sara, Castilla Lucía, Blanco María Jesús, Gutiérrez María Del Mar, Rivas Isabel, Pascual Cristina, Rosado Belén, Sola Elena, Vidal-Laso Rosa, Asenjo Susana, Mora Casado María Asunción, Benito-Parra Laurentino, Carmona Itziar, Marín Karen, Acedo Natalia, García-León Natalia, Marcheco Alexis, Guillén Carolina, Fernández Cristina, Rodríguez Ramón, Pardo Laura, Silva Pablo, Montero Laura, Meijón Mar, Massó Pilar, Llamas-Sillero Pilar

机构信息

Hematology Department, University Hospital Fundación Alcorcón, Madrid, Spain.

Hematology Department, University Hospital Fundación Jiménez Díaz, Madrid, Spain; Hematology Department, Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Madrid, Spain.

出版信息

Thromb Res. 2021 Jul;203:93-100. doi: 10.1016/j.thromres.2021.05.001. Epub 2021 May 8.

Abstract

BACKGROUND

COVID-19 related in-hospital venous thromboembolism (VTE) incidence is high but data reported vary significantly. Some studies show that up to half of the events are diagnosed early after admission.

OBJECTIVES

To study symptomatic VTE incidence in acute COVID-19 hospitalized patients and to describe timing of VTE diagnosis.

METHODS

Multicenter cohort of 5966 patients hospitalized with acute COVID-19. Multicenter Registry of 844 hospitalized patients with acute COVID-19 and associated acute VTE.

RESULTS

By the time of cohort data collection, 68 patients (1.14%) were still hospitalized, 19.8% had died, and 5.4% required ICU. During a median follow-up of 6 days (IQR, 4-12), 183 patients (3.07%; 95% CI, 2.64-3.55) presented a symptomatic VTE event. The cumulative incidences of VTE at 7, 14 and 21 days in wards [2.3% (95% CI, 1.9-2.7), 3.6% (95% CI, 3.0-4.3), and 4.3% (95% CI, 3.5-5.1)] were similar to the ones reported in ICU [2.2% (95% CI, 1.0-4.4), 2.9% (95% CI, 1.5-5.3), and 4.1% (95% CI, 2.2-6.8)], but at 30 and 60 days were higher in ICU [6.9% (95% CI, 4.2-10.5), and 12.8% (95% CI, 8.1-18.5)] than in wards. Eighty-eight VTE events (48%) were diagnosed early, within 48 h of admission. VTE was not associated with death (HR, 0.79; 95% CI, 0.55-1.12).

CONCLUSIONS

Incidence of symptomatic VTE in our COVID-19 cohort is consistent with that of other real-life studies recently published. Early VTE events are, along with COVID-19, the reason for admission rather than an in-hospital complication.

摘要

背景

新型冠状病毒肺炎(COVID-19)相关的院内静脉血栓栓塞症(VTE)发生率较高,但报告的数据差异显著。一些研究表明,高达一半的此类事件在入院后早期被诊断出来。

目的

研究急性COVID-19住院患者的症状性VTE发生率,并描述VTE的诊断时间。

方法

对5966例急性COVID-19住院患者进行多中心队列研究。对844例急性COVID-19住院患者及相关急性VTE患者进行多中心登记。

结果

在收集队列数据时,68例患者(1.14%)仍住院,19.8%已死亡,5.4%需要入住重症监护病房(ICU)。在中位随访6天(四分位间距,4-12天)期间,183例患者(3.07%;95%置信区间,2.64-3.55)出现症状性VTE事件。病房中VTE在7天、14天和21天的累积发生率[2.3%(95%置信区间,1.9-2.7)、3.6%(95%置信区间,3.0-4.3)和4.3%(95%置信区间,3.5-5.1)]与ICU中的发生率[2.2%(95%置信区间,1.0-4.4)、2.9%(95%置信区间,1.5-5.3)和4.1%(95%置信区间,2.2-6.8)]相似,但在30天和60天时,ICU中的发生率[6.9%(95%置信区间,4.2-10.5)和12.8%(95%置信区间,8.1-18.5)]高于病房。88例VTE事件(48%)在入院后48小时内被早期诊断。VTE与死亡无关(风险比,0.79;95%置信区间,0.55-1.12)。

结论

我们的COVID-19队列中症状性VTE的发生率与最近发表的其他实际研究一致。早期VTE事件与COVID-19一样,是入院的原因而非院内并发症。

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