Zhang Jianjun, Chen Yan, Wang Zhicong, Chen Xi, Liu Yuehong, Liu Mozhen
Department of Orthopedics, People's Hospital of Deyang City, Deyang, China.
Department of Orthopedics, The First Affiliated Hospital of Dalian Medical University, Dalian, China.
Front Cardiovasc Med. 2023 Mar 22;10:1154875. doi: 10.3389/fcvm.2023.1154875. eCollection 2023.
To investigate the potential relationship between anatomic distribution of lower extremity deep venous thrombosis (LEDVT) and pulmonary embolism (PE).
A retrospective case-control study was performed in patients diagnosed with LEDVT, which were confirmed by bilateral lower extremity compression ultrasonography (CUS) examination. According to the ultrasound reports, thrombus sidedness was categorized as unilateral and bilateral lower extremity, thrombus location was classified into distal and proximal LEDVT. Anatomic distributions of LEDVT were further subdivided depending on the combination of thrombus sidedness and location. Patients with PE were identified using the International Classification of Diseases-10 (ICD-10) codes (I26.0 and I26.9), and divided into PE group and Non-PE group. Univariate and multivariate logistic regression analyses were used to assess the association between anatomic distribution of LEDVT and PE. Sensitivity analyses were also conducted.
A total of 2,363 consecutive patients with LEDVT were included, of whom 66.10% and 33.90% were unilateral and bilateral LEDVT, as well as 71.39% and 28.61% were isolated distal and proximal LEDVT, respectively. After the diagnosis of LEDVT, 185 patients (7.83%) developed PE. The proportions of PE ranged between the lowest (4.07%) in unilateral-distal LEDVT and highest (14.55%) in bilateral-proximal LEDVT. Multivariate logistic regression analysis showed that bilateral LEDVT (odds ratios [OR] = 2.455, 95% confidence interval [CI]: 1.803-3.344, < 0.001) and proximal LEDVT (OR = 1.530, 95% CI: 1.105-2.118, = 0.010) were risk factors for developing PE. Moreover, unilateral-proximal (OR = 2.129, 95% CI: 1.365-3.320, = 0.00), bilateral-distal (OR = 3.193, 95% CI: 2.146-4.752, < 0.001) and bilateral-proximal LEDVT(OR = 3.425, 95% CI: 2.093-5.603, < 0.001) were significantly associated with an increased risk of PE. Sensitivity analyses also confirmed the robustness of these associations.
Patients with unilateral-proximal, bilateral-distal or bilateral-proximal are more likely to suffer from PE than those with unilateral-distal LEDVT.
探讨下肢深静脉血栓形成（LEDVT）的解剖分布与肺栓塞（PE）之间的潜在关系。
对经双侧下肢压迫超声检查（CUS）确诊为LEDVT的患者进行回顾性病例对照研究。根据超声报告，血栓部位分为单侧和双侧下肢，血栓位置分为远端和近端LEDVT。LEDVT的解剖分布根据血栓部位和位置的组合进一步细分。使用国际疾病分类第10版（ICD-10）编码（I26.0和I26.9）确定PE患者，并分为PE组和非PE组。采用单因素和多因素logistic回归分析评估LEDVT的解剖分布与PE之间的关联。还进行了敏感性分析。
共纳入2363例连续的LEDVT患者，其中66.10%为单侧LEDVT，33.90%为双侧LEDVT，71.39%为孤立性远端LEDVT，28.61%为近端LEDVT。在诊断为LEDVT后，185例患者（7.83%）发生了PE。PE的比例在单侧远端LEDVT中最低（4.07%），在双侧近端LEDVT中最高（14.55%）。多因素logistic回归分析显示，双侧LEDVT（比值比[OR]=2.455，95%置信区间[CI]：1.803-3.344，P<0.001）和近端LEDVT（OR=1.530，95%CI：1.105-2.118，P=0.010）是发生PE的危险因素。此外，单侧近端（OR=2.129，95%CI：1.365-3.320，P=0.00）、双侧远端（OR=3.193，95%CI：2.146-4.752，P<0.001）和双侧近端LEDVT（OR=3.425，95%CI：2.093-5.603，P<0.001）与PE风险增加显著相关。敏感性分析也证实了这些关联的稳健性。
与单侧远端LEDVT患者相比，单侧近端、双侧远端或双侧近端LEDVT患者更易发生PE。
