Department of Internal Medicine, Staten Island University Hospital/Northwell Health, 475 Seaview Ave, Staten Island, NY, 10305, USA.
Department of Pulmonary and Critical Care, Staten Island University Hospital/Northwell Health, Staten Island, NY, USA.
J Thromb Thrombolysis. 2024 Feb;57(2):220-225. doi: 10.1007/s11239-023-02906-7. Epub 2023 Oct 17.
Primary hyperthyroidism (PHPT) is a relatively uncommon disease and leads to increased calcium levels. Ionized calcium, known as clotting Factor IV, may lead to overt coagulation cascade activation, increasing the risk of venous thromboembolism (VTE). National Inpatient Sample Database was used to sample individuals with primary hyperparathyroidism, and baseline demographics and comorbidities were collected using ICD-10 codes. Patients with missing data and age less than 18 were excluded. Moreover, patients with other types of hyperparathyroidism and risk factors for VTE, such as malignancy, thrombophilia, chronic kidney and liver disease, fractures, trauma, oral contraceptive/steroid use, and organ transplant, were excluded. Greedy propensity matching using R was performed to match patients with and without primary hyperparathyroidism on age, race, gender, and 10 other comorbidities, including chronic deep venous thromboembolism. Univariate analysis pre- and post-match were performed. Binary logistic regression was performed after matching to assess whether primary hyperparathyroidism was an independent risk factor for acute VTE. A p-value of < 0.05 was considered statistically significant. Out of 460,529 patients included in the study, 1114 (6.5%) had PHPT. Baseline comorbidities were more common in the PHPT group. On univariate analysis, patients with PHPT were more likely to have acute VTE (2.5% vs. 1.4%; p < 0.001). After 1:1 matching, PHPT patients were twice as likely to have Acute VTE. (OR: 2.1 [1.08-4.1]; p < 0.025). These findings suggest an association between PHPT and VTE, which should be further investigated to prevent the increasing incidence of VTE and its recurrence.
原发性甲状旁腺功能亢进症（PHPT）是一种相对罕见的疾病，可导致血钙水平升高。离子钙，即凝血因子 IV，可能导致明显的凝血级联激活，增加静脉血栓栓塞症（VTE）的风险。本研究使用国家住院患者样本数据库对原发性甲状旁腺功能亢进症患者进行抽样，并使用 ICD-10 代码收集基线人口统计学和合并症数据。排除数据缺失和年龄小于 18 岁的患者。此外，排除患有其他类型甲状旁腺功能亢进症和 VTE 风险因素的患者，如恶性肿瘤、血栓形成倾向、慢性肾脏和肝脏疾病、骨折、外伤、口服避孕药/类固醇使用和器官移植。使用 R 进行贪婪倾向匹配，根据年龄、种族、性别和其他 10 种合并症（包括慢性深部静脉血栓形成）匹配患有和不患有原发性甲状旁腺功能亢进症的患者。进行匹配前后的单变量分析。匹配后进行二项逻辑回归分析，以评估原发性甲状旁腺功能亢进症是否为急性 VTE 的独立危险因素。p 值<0.05 被认为具有统计学意义。在纳入研究的 460529 名患者中，有 1114 名（6.5%）患有 PHPT。PHPT 组的基线合并症更为常见。在单变量分析中，患有 PHPT 的患者更有可能发生急性 VTE（2.5%比 1.4%；p<0.001）。匹配后 1:1 匹配，PHPT 患者发生急性 VTE 的可能性是对照组的两倍。（OR：2.1 [1.08-4.1]；p<0.025）。这些发现表明 PHPT 与 VTE 之间存在关联，应进一步研究以预防 VTE 发生率的增加及其复发。
