AlSheef Mohammed, Alshammari Fouad Taiwilaa, Alhawish Mashel Khalid, Alghamdi Abduljabar Ghazi, Alqudhybi Abdullah Fahad, Abu-Shaheen Amani
King Fahad Medical City, Riyadh, Saudi Arabia.
Research Center, King Fahad Medical City, Riyadh, Saudi Arabia.
Front Cardiovasc Med. 2022 Jul 22;9:928094. doi: 10.3389/fcvm.2022.928094. eCollection 2022.
Venous thromboembolism (VTE) is a major health concern, with an annual incidence of ~1 in 1,000. The epidemiology of VTE in Saudi Arabia has not been adequately described yet. Therefore, this study aimed to assess the clinical characteristics, risk factors, diagnostic methods, management, and clinical outcomes of patients with VTE.
This study was based on a VTE registry created over ten years at King Fahad Medical City (KFMC) in Riyadh, Saudi Arabia. All adult inpatients and outpatients referred to the thrombosis unit of the KFMC with clinically suspected VTE including pulmonary embolism (PE) and deep vein thrombosis (DVT) were enrolled. Data were collected using a standardized case report form, which included demographic and clinical characteristics, risk factors, diagnostic methods, management, and outcomes.
A total of 1,008 patients were recruited. Most patients were women (73.2%), and more than half of all patients had unprovoked VTE (58%). Among the provoked cases, the most frequent cause was surgery (29.8%), followed by hospitalization (24.2%). There was a significant statistical association between provoked status and sex, family history of VTE, smoking, recent hospitalization within 3 months for a medical condition, the site of VTE, and underlying peripheral vascular disease and varicose veins (all < 0.05). The majority (88.3%) of patients with deep vein thrombosis was hospitalized for ≤3 days ( = 433, 79.9%), while fewer than half of the patients with PE needed hospitalization (45.3%). Thrombolytic therapy was administered to 14.1% ( = 142) of patients, and catheter-directed thrombolysis was performed in 1.0% ( = 10) of patients. The odds of mortality for provoked VTE were 3.20 times higher than those of unprovoked VTE [2.12-4.83; -value < 0.001].
Unprovoked VTE was more common than provoked VTE in the Saudi Arabian cohort, implying hereditary predisposition. Furthermore, male sex, family history of VTE, prior history of VTE, type of VTE, underlying obesity, history of trauma, surgery, hospitalization, pregnancy, and 3-6 months of anticoagulation therapy were the most critical risk factors for VTE recurrence. The treatment patterns and clinical results were comparable to those reported in the literature.
静脉血栓栓塞症（VTE）是一个主要的健康问题，年发病率约为千分之一。沙特阿拉伯VTE的流行病学尚未得到充分描述。因此，本研究旨在评估VTE患者的临床特征、危险因素、诊断方法、治疗及临床结局。
本研究基于沙特阿拉伯利雅得法赫德国王医疗城（KFMC）建立超过十年的VTE登记册。所有因临床疑似VTE（包括肺栓塞（PE）和深静脉血栓形成（DVT））转诊至KFMC血栓科的成年住院和门诊患者均被纳入。使用标准化病例报告表收集数据，该表包括人口统计学和临床特征、危险因素、诊断方法、治疗及结局。
共招募了1008例患者。大多数患者为女性（73.2%），超过半数患者发生不明原因的VTE（58%）。在有诱因的病例中，最常见的原因是手术（29.8%），其次是住院（24.2%）。诱因状态与性别、VTE家族史、吸烟、3个月内因疾病近期住院、VTE部位以及潜在的外周血管疾病和静脉曲张之间存在显著统计学关联（均P<0.05）。大多数（88.3%）深静脉血栓形成患者住院时间≤3天（n = 433，79.9%），而需要住院的肺栓塞患者不到半数（45.3%）。14.1%（n = 142）的患者接受了溶栓治疗，1.0%（n = 10）的患者进行了导管定向溶栓。有诱因的VTE患者的死亡几率比不明原因的VTE高3.20倍[2.12 - 4.83；P值<0.001]。
在沙特阿拉伯队列中，不明原因的VTE比有诱因的VTE更常见，这意味着存在遗传易感性。此外，男性、VTE家族史、VTE既往史、VTE类型、潜在肥胖、创伤史既往史、手术、住院、妊娠以及3 - 6个月的抗凝治疗是VTE复发的最关键危险因素。治疗模式和临床结果与文献报道相当。
