深静脉血栓形成对慢性阻塞性肺疾病合并肺栓塞患者 90 天死亡率的影响。

The impact of deep venous thrombosis on 90 day mortality in chronic obstructive pulmonary disease patients presenting with pulmonary embolism.

机构信息

University of Health Sciences, Yedikule Chest Disease and Thoracic Surgery Training and Research Hospital, Chest Disease, Turkey.

出版信息

Respir Med Res. 2024 Jun;85:101090. doi: 10.1016/j.resmer.2024.101090. Epub 2024 Feb 15.

DOI:10.1016/j.resmer.2024.101090

PMID:38657301

Abstract

BACKGROUND

There are a limited number of studies investigating the effect of deep venous thrombosis (DVT) in patients presenting with both pulmonary embolism and chronic obstructive pulmonary disease. The aim of this study is to investigate the prevalence and prognostic significance of DVT in patients with PE-COPD.

METHODS

COPD patients admitted with a diagnosis of PE to our tertiary hospital between January 2016 and January 2021 were retrospectively evaluated with an electronic hospital database. Univariate and multivariate Cox regression analyses were performed to reveal independent prognostic factors.

RESULTS

Two hundred thirty-three patients (mean age 65.1 ± 12.2, 158 men (67.5 %)) were included. DVT was present at the time of diagnosis in 45 (19.31 %) of the patients. Patients with DVT tend to have more comorbidities, central pulmonary embolism, higher CRP and d-dimer levels, and SPESI score (p<0.05). After performing multivariate analyses, the presence of DVT (HR=3.48, CI: 1.02- 11.88, p = 0.046), ischemic heart disease (HR=3.82, CI: 1.38- 10.80, p = 0.01), and malignancy (HR=4.85, CI: 1.53- 15.41, p = 0.007) were found to be independent factors in predicting 90-day mortality.

CONCLUSIONS

In PE-COPD patients, co-existing DVT may predict a worse outcome.

摘要

背景

目前仅有少数研究调查了同时患有肺栓塞（PE）和慢性阻塞性肺疾病（COPD）患者的深静脉血栓（DVT）的影响。本研究旨在调查 PE-COPD 患者中 DVT 的患病率和预后意义。

方法

我们对 2016 年 1 月至 2021 年 1 月期间因 PE 入住我院的 COPD 患者进行回顾性电子病历数据库评估。进行单变量和多变量 Cox 回归分析以揭示独立的预后因素。

结果

共纳入 233 例患者（平均年龄 65.1 ± 12.2 岁，158 例男性[67.5%]）。45 例（19.31%）患者在诊断时存在 DVT。患有 DVT 的患者往往具有更多的合并症、中央型肺栓塞、更高的 CRP 和 D-二聚体水平以及 SPESI 评分（p<0.05）。进行多变量分析后，发现 DVT 的存在（HR=3.48，CI：1.02-11.88，p=0.046）、缺血性心脏病（HR=3.82，CI：1.38-10.80，p=0.01）和恶性肿瘤（HR=4.85，CI：1.53-15.41，p=0.007）是预测 90 天死亡率的独立因素。