Zhang Jinlong, Fang Yunyun, Pang Haiyun, Tao Ye, Zhou Jing, Zhu Shanshan, Wang Cheng
Rehabilitation Department, Hefei BOE Hospital of BOE Technology Group, Hefei, Anhui Province, People's Republic of China.
Rehabilitation Department, First Affiliated Hospital of University of Science and Technology of China (Anhui Provincial Hospital), Hefei, Anhui Province, People's Republic of China.
Spinal Cord. 2022 Jan;60(1):90-98. doi: 10.1038/s41393-021-00647-z. Epub 2021 Jun 1.
Article.
To elucidate the association of age-adjusted D-dimer (AAD) with deep vein thrombosis (DVT) risk to lower limbs in patients with spinal cord injury (SCI).
Rehabilitation Medicine Department of the First Affiliated Hospital of China University of Science and Technology.
Retrospective analysis of 250 patients with SCI in the rehabilitation department from August 2018 to December 2021. Quartiles divided the D-dimer level into four groups to analyze the association between AAD level and DVT risk.
Age was identified as a covariate of D-dimer and DVT risk. For non-adjusted model, when D-dimer increased by 1 mg/L, DVT risk increased 0.23-fold (P < 0.05); for minimally-adjusted model (adjusted for age), the risk increased 0.22-fold (P < 0.05); and for fully-adjusted model (adjusted for age, sex, pulmonary infection, degree, grades, and career), it increased 0.19-fold (P < 0.05). AAD had a curvilinear association with DVT risk, and the fold point was 1.9 mg/L (P < 0.05). When serum AAD level was <1.9 mg/L (K < 1.9), the estimated change in DVT risk was 3.34 (P < 0.05), and when serum AAD level was >1.9 mg/L (K > 1.9), the estimated change was 1.14 (P < 0.05). Urinary tract infection (UTI) and fibrinogen(tertile) had a interaction association with D-dimer level and DVT risk (P interaction < 0.05).
Patients with SCI who receive rehabilitation treatment with AAD level >1.9 mg/L need to be paid close attention to, especially those with UTI and high levels of fibrinogen.
文章。
阐明年龄校正D-二聚体(AAD)与脊髓损伤(SCI)患者下肢深静脉血栓形成(DVT)风险之间的关联。
中国科学技术大学附属第一医院康复医学科。
回顾性分析2018年8月至2021年12月康复科250例SCI患者。四分位数将D-二聚体水平分为四组,分析AAD水平与DVT风险之间的关联。
年龄被确定为D-二聚体和DVT风险的协变量。对于未校正模型,当D-二聚体增加1mg/L时,DVT风险增加0.23倍(P<0.05);对于最小校正模型(校正年龄),风险增加0.22倍(P<0.05);对于完全校正模型(校正年龄、性别、肺部感染、程度、分级和职业),风险增加0.19倍(P<0.05)。AAD与DVT风险呈曲线关联,转折点为1.9mg/L(P<0.05)。当血清AAD水平<1.9mg/L(K<1.9)时,DVT风险的估计变化为3.34(P<0.05),当血清AAD水平>1.9mg/L(K>1.9)时,估计变化为1.14(P<0.05)。尿路感染(UTI)和纤维蛋白原(三分位数)与D-二聚体水平和DVT风险存在交互关联(P交互<0.05)。
AAD水平>1.9mg/L的接受康复治疗的SCI患者需要密切关注,尤其是那些患有UTI和纤维蛋白原水平高的患者。