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新型冠状病毒肺炎住院患者血栓栓塞事件的发生率及相关危险因素:一项回顾性研究

Incidence and Risk Factors Associated with Thromboembolic Events among Patients with COVID-19 Inpatients: A Retrospective Study.

作者信息

Tashkandi Wail Abdulhafez

机构信息

Department of Surgery, Faculty of Medicine, King Abdulaziz University Hospital, King Abdulaziz University, Jeddah, Saudi Arabia.

出版信息

Indian J Crit Care Med. 2023 Nov;27(11):830-836. doi: 10.5005/jp-journals-10071-24575.

Abstract

AIMS AND OBJECTIVES

Despite thromboprophylaxis, some severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) patients develop thrombotic complications with poor prognosis. Our goal is to comprehensively assess the incidence, risk factors, and clinical outcomes associated with thromboembolic events (TE) among adult patients presenting with coronavirus disease-2019 (COVID-19).

MATERIALS AND METHODS

The study was conducted as an observational and retrospective study across COVID-19 patients ( = 207) in a tertiary care hospital in the Middle East and North Africa (MENA) region. Electronic health records were collected from the COVID-19 Database from April 2020 to December 2020 which included clinical history and TE.

RESULTS

Fifty-six (27.05%) out of 207 patients (age: 54.42 ± 15.01 years) developed TE despite the anticoagulant therapy. The incidence of venous thromboembolism (VTE) was significantly higher for patients aged >50 years compared to <50 years (73.21% vs 26.79%, < 0.05). There were no differences in the incidence of VTE between genders ( = 0.561). 165 patients (79.71%) received anticoagulant therapy, yet 48 (29%) developed TE. The most commonly used anticoagulant was low-molecular-weight heparin (LMWH, 47.34%). In spite of efficient treatment and medical management, the majority of patients with TE (45 out of 56 patients, 80.35%) experienced mortality. The comorbidities that significantly increase the risk of TE include hypertension (HTN) and ischemic heart disease (IHD). The laboratory parameters that were associated with an increased risk of VTE include ferritin, lactate dehydrogenase (LDH), and creatinine.

CONCLUSION

The COVID-19 patients develop thrombotic complications. Future studies should clarify the underlying mechanisms of TE and optimize the antithrombotic regimens in COVID-19 patients.

HOW TO CITE THIS ARTICLE

Tashkandi WA. Incidence and Risk Factors Associated with Thromboembolic Events among Patients with COVID-19 Inpatients: A Retrospective Study. Indian J Crit Care Med 2023;27(11):830-836.

摘要

目的与目标

尽管采取了血栓预防措施,但一些严重急性呼吸综合征冠状病毒2(SARS-CoV-2)患者仍会出现血栓形成并发症,预后较差。我们的目标是全面评估2019冠状病毒病(COVID-19)成年患者中与血栓栓塞事件(TE)相关的发病率、危险因素和临床结局。

材料与方法

本研究是在中东和北非(MENA)地区一家三级护理医院对COVID-19患者(n = 207)进行的一项观察性回顾性研究。从2020年4月至2020年12月的COVID-19数据库中收集电子健康记录,其中包括临床病史和TE。

结果

207例患者(年龄:54.42±15.01岁)中,56例(27.05%)尽管接受了抗凝治疗仍发生了TE。年龄>50岁的患者静脉血栓栓塞(VTE)发生率显著高于<50岁的患者(73.21%对26.79%,P<0.05)。VTE发生率在性别之间无差异(P = 0.561)。165例患者(79.71%)接受了抗凝治疗,但仍有48例(29%)发生了TE。最常用的抗凝剂是低分子量肝素(LMWH,47.34%)。尽管进行了有效的治疗和医疗管理,但大多数TE患者(56例中的45例,80.35%)死亡。显著增加TE风险的合并症包括高血压(HTN)和缺血性心脏病(IHD)。与VTE风险增加相关的实验室参数包括铁蛋白、乳酸脱氢酶(LDH)和肌酐。

结论

COVID-19患者会出现血栓形成并发症。未来的研究应阐明TE的潜在机制,并优化COVID-19患者的抗血栓治疗方案。

如何引用本文

Tashkandi WA。COVID-19住院患者血栓栓塞事件的发生率及相关危险因素:一项回顾性研究。《印度重症监护医学杂志》2023;27(11):830 - 836。

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