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意义未明的单克隆丙种球蛋白病患者的急性静脉血栓栓塞事件:基于国家住院患者样本的分析

Acute venous thromboembolic events in patients with monoclonal gammopathy of undetermined significance: An analysis of the National Inpatient Sample.

作者信息

Abdelhay Ali, Mahmoud Amir A, Mostafa Mariam, Al Ali Omar, Gill Simrat, Jamshed Saad

机构信息

Department of Internal Medicine, Rochester General Hospital, Rochester, NY, USA.

Department of Internal Medicine, Rochester General Hospital, Rochester, NY, USA.

出版信息

Thromb Res. 2023 May;225:28-32. doi: 10.1016/j.thromres.2023.02.014. Epub 2023 Mar 1.

Abstract

BACKGROUND

Monoclonal Gammopathy of Undetermined Significance (MGUS) is a premalignant plasma cell disorder which despite being clinically silent carries an increased risk of venous thromboembolism (VTE). We conducted a population-based study to investigate the risk of VTE in these patients.

METHODS

We utilized the National Inpatient Sample (NIS) for the year 2016 to compare the incidence of acute VTE between patients who carry the diagnosis of MGUS and those who don't. We excluded hospitalizations with age < 18 years and those that had a diagnosed lymphoma, leukemia, solid malignancy, or other plasma cell dyscrasia. We utilized the ICD-10-CM coding system to search the database for codes of VTE, MGUS, and other comorbid conditions. Multivariate logistic regression models were used for comparative analysis adjusting for demographic characteristics and comorbidities. Baseline comorbidities were described as frequencies and proportions for categorical variables and as medians with interquartile ranges for continuous variables.

RESULTS

A total of 33,115 weighted hospitalizations were included in the MGUS group. These were compared to 27,418,403 weighted hospitalizations without the diagnosis of MGUS. The MGUS group had higher odds of composite venous thromboembolism (adjusted OR 1.33, 95 % CI 1.22-1.44), deep vein thrombosis (adjusted OR 1.46, 95 % CI 1.29-1.65), and pulmonary embolism (adjusted OR 1.22, 95 % CI 1.09-1.37).

CONCLUSION

Patients with MGUS had increased odds of developing acute venous thromboembolism compared to patients with no history of MGUS.

摘要

背景

意义未明的单克隆丙种球蛋白病(MGUS)是一种癌前浆细胞疾病,尽管临床上无症状,但静脉血栓栓塞(VTE)风险增加。我们进行了一项基于人群的研究,以调查这些患者发生VTE的风险。

方法

我们利用2016年的全国住院患者样本(NIS),比较诊断为MGUS的患者与未诊断为MGUS的患者之间急性VTE的发生率。我们排除了年龄<18岁的住院患者以及诊断为淋巴瘤、白血病、实体恶性肿瘤或其他浆细胞发育异常的患者。我们使用ICD-10-CM编码系统在数据库中搜索VTE、MGUS和其他合并症的编码。多变量逻辑回归模型用于调整人口统计学特征和合并症的比较分析。基线合并症按分类变量的频率和比例以及连续变量的中位数和四分位间距进行描述。

结果

MGUS组共纳入33,115例加权住院患者。将这些患者与27,418,403例未诊断为MGUS的加权住院患者进行比较。MGUS组发生复合静脉血栓栓塞(调整后的OR为1.33,95%CI为1.22-1.44)、深静脉血栓形成(调整后的OR为1.46,95%CI为1.29-1.65)和肺栓塞(调整后的OR为1.22,95%CI为1.09-1.37)的几率更高。

结论

与无MGUS病史的患者相比,MGUS患者发生急性静脉血栓栓塞的几率增加。

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