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易患静脉血栓栓塞症的成年患者在服用抗精神病药物后发生导致住院的静脉血栓栓塞事件的风险。

The Risk of Venous Thromboembolism Events Resulting in Hospitalization following Exposure to Antipsychotic Medication in Pre-Disposed Adult Patients.

作者信息

Kahle Rachel, Sjoquist Laura, Ferraro Lindsey

机构信息

University of Findlay (Findlay, Ohio).

James E. Van Zandt VA Medical Center.

出版信息

Innov Pharm. 2024 May 31;15(2). doi: 10.24926/iip.v15i2.6116. eCollection 2024.

DOI:10.24926/iip.v15i2.6116
PMID:39166148
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11333103/
Abstract

: The primary objective of this study was to compare the incidence of antipsychotic use in those with venous thromboembolism (VTE) resulting in hospital admission. This study expands upon current knowledge regarding VTE risk and antipsychotic use and investigates potential risk factors and lab values that may precede antipsychotic-induced coagulopathy. : This retrospective, case-control, chart review investigated patients admitted to an acute care hospital with either a VTE or non-VTE diagnosis. Primary outcome analysis compared the presence of an antipsychotic medication in patients who had a VTE versus those who did not. Secondary analysis included: 1) the duration, class, dose, frequency, and route of antipsychotic and 2) coagulation parameters, patient characteristics, and VTE risk factors. : Analysis included 400 participants with 200 participants in each group (VTE and non-VTE). Of the 51 patients who received an antipsychotic, 29 (56.9%) developed or presented with a VTE. However, there was no significant difference in VTE development between groups when controlled for antipsychotic use (OR 1.37, 95% CI 0.76-2.50, P-value=0.30). : While primary study findings were not statistically significant, results support a weak association of exposure to antipsychotic(s) in VTE groups compared to control (non-VTE). Obesity significantly increased the odds of VTE whereas a history of type 2 diabetes significantly decreased the odds of VTE.

摘要

本研究的主要目的是比较因静脉血栓栓塞症(VTE)入院患者中使用抗精神病药物的发生率。本研究扩展了关于VTE风险和抗精神病药物使用的现有知识,并调查了可能先于抗精神病药物引起的凝血病的潜在风险因素和实验室值。:这项回顾性病例对照图表审查研究了入住急性护理医院且诊断为VTE或非VTE的患者。主要结局分析比较了发生VTE的患者与未发生VTE的患者中抗精神病药物的使用情况。次要分析包括:1)抗精神病药物的使用持续时间、类别、剂量、频率和途径,以及2)凝血参数、患者特征和VTE风险因素。:分析纳入了400名参与者,每组200名(VTE组和非VTE组)。在51名接受抗精神病药物治疗的患者中,29名(56.9%)发生或出现了VTE。然而,在控制抗精神病药物使用后,两组之间VTE的发生没有显著差异(OR 1.37,95%CI 0.76 - 2.50,P值 = 0.30)。:虽然主要研究结果在统计学上不显著,但结果支持VTE组与对照组(非VTE组)相比,抗精神病药物暴露存在弱关联。肥胖显著增加了VTE的几率,而2型糖尿病病史显著降低了VTE几率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/daa7/11333103/95a9489b1baf/21550417-15-02-6116_Fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/daa7/11333103/95a9489b1baf/21550417-15-02-6116_Fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/daa7/11333103/95a9489b1baf/21550417-15-02-6116_Fig1.jpg

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本文引用的文献

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J Atheroscler Thromb. 2024 Apr 1;31(4):396-418. doi: 10.5551/jat.64461. Epub 2023 Nov 30.
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A pharmacovigilance study of the association between antipsychotic drugs and venous thromboembolism based on Food and Drug Administration Adverse Event Reporting System data.基于食品和药物管理局不良事件报告系统数据的抗精神病药物与静脉血栓栓塞症关联性的药物警戒研究。
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Asian J Psychiatr. 2022 Jul;73:103105. doi: 10.1016/j.ajp.2022.103105. Epub 2022 Apr 12.
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Antipsychotic Use Is Associated With Longer In-hospital Lengths of Stay and Higher Rates of Venous Thromboembolism and Costs of Care After Primary Total Knee Arthroplasty.抗精神病药物的使用与初次全膝关节置换术后住院时间延长、静脉血栓栓塞发生率和医疗费用增加有关。
J Am Acad Orthop Surg. 2021 Jul 1;29(13):e675-e680. doi: 10.5435/JAAOS-D-20-00726.
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Characteristics of U.S. adults taking prescription antipsychotic medications, National Health and Nutrition Examination Survey 2013-2018.美国成年人服用处方抗精神病药物的特征,2013-2018 年全国健康和营养调查。
BMC Psychiatry. 2020 Oct 1;20(1):483. doi: 10.1186/s12888-020-02895-4.
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The Association and Influencing Factors between Antipsychotics Exposure and the Risk of VTE and PE: A Systematic Review and Meta-analysis.抗精神病药物暴露与静脉血栓栓塞症和肺栓塞风险之间的关联及影响因素:一项系统评价和荟萃分析。
Curr Drug Targets. 2020;21(9):930-942. doi: 10.2174/1389450121666200422084414.
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