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危重症流感患者的血栓栓塞症:发生率及危险因素。

Thrombosis in Critically Ill Influenza Patients: Incidence and Risk Factors.

机构信息

Department of Critical Care Medicine, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, China.

Shandong Institute of Respiratory Diseases, Jinan, China.

出版信息

Clin Appl Thromb Hemost. 2024 Jan-Dec;30:10760296241278615. doi: 10.1177/10760296241278615.

Abstract

Influenza infection is associated with a risk of thrombosis. Whether factors associated with reduced thrombosis might also be associated with reduced risk in patients with severe influenza is unknown. To investigate risk factors associated with thrombosis in patients with severe influenza. We used a cohort data set to identify adults diagnosed with severe influenza. Univariable and multivariable logistic regression models explored potential risk factors for thrombosis events in patients with severe influenza. Cox regression analysis was used to examine the risk factors for mortality in patients with severe influenza. A total of 854 patients with severe influenza were included in the analysis. The incidence of VTE was 9.37% (80/854). Multivariable regression analysis showed that previous aspirin medication (OR: 0.37; 95%CI: 0.14-0.84;  = .029) could reduce the risk factor of thrombosis in patients with severe influenza. Compared with patients in the non-thrombosis group, patients in the thrombosis group required more mechanical ventilation ( < .001), tracheostomy ( < .001), ECMO ( = .046), and high-frequency ventilation ( = .004). The incidence of co-infection was higher in the thrombosis group compared to the non-thrombosis group ( = .025). Univariable Cox regression analysis showed that previous aspirin medication (HR 0.52, 95%CI: 0.33-0.82,  = .005) and previous statin medication (HR 0.54, 95%CI: 0.34-0.87,  = .011) were risk factors for 60-day mortality in patients with severe influenza. Patients with severe influenza are at high risk for thrombosis. The effect of aspirin on thrombosis in patients with severe influenza needs further investigation.

摘要

流感感染与血栓形成的风险相关。尚不清楚与降低严重流感患者血栓形成风险相关的因素是否也与降低严重流感患者的风险相关。本研究旨在探讨严重流感患者发生血栓形成的相关危险因素。我们使用队列数据集来确定诊断为严重流感的成年人。单变量和多变量逻辑回归模型探索了严重流感患者发生血栓事件的潜在危险因素。Cox 回归分析用于检查严重流感患者的死亡风险因素。共纳入 854 例严重流感患者进行分析。VTE 的发生率为 9.37%(80/854)。多变量回归分析显示,既往阿司匹林治疗(OR:0.37;95%CI:0.14-0.84; = .029)可降低严重流感患者的血栓形成风险因素。与非血栓组患者相比,血栓组患者需要更多的机械通气( < .001)、气管切开术( < .001)、ECMO( = .046)和高频通气( = .004)。与非血栓组相比,血栓组的合并感染发生率更高( = .025)。单变量 Cox 回归分析显示,既往阿司匹林治疗(HR 0.52,95%CI:0.33-0.82, = .005)和既往他汀类药物治疗(HR 0.54,95%CI:0.34-0.87, = .011)是严重流感患者 60 天死亡的风险因素。严重流感患者发生血栓的风险较高。阿司匹林对严重流感患者血栓形成的影响需要进一步研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dc7e/11348485/891d8f3c744f/10.1177_10760296241278615-fig1.jpg

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