Medical Research Group of Egypt, Negida Academy, Arlington, MA, USA.
Faculty of Medicine, Menoufia University, Shibin El-Kom, Egypt.
Tunis Med. 2024 Oct 5;102(10):610-515. doi: 10.62438/tunismed.v102i10.5154.
This systematic review and meta-analysis aimed to determine the annual incidence rate of venous thromboembolism (VTE) and identify risk factors of VTE in amyotrophic lateral sclerosis (ALS) patients.
A comprehensive search of three databases was conducted up to April 8, 2024, to identify longitudinal studies reporting VTE incidence in ALS patients. The included studies were either prospective or retrospective, following up with ALS patients. Quality assessment was performed using the NIH tool for observational cohort studies. Meta-analysis was conducted using Open Meta Analyst, employing a random-effect model. Subgroup, Meta-regression, and sensitivity analyses were also carried out.
Our analysis included eight studies comprising a total of 26,758 ALS patients that met the inclusion criteria. The pooled annual incidence of VTE across all studies was found to be 22 cases per 1,000 person-year (95% CI = 18 to 27). Subgroup analysis revealed that the annual incidence of VTE in males was 19 cases per 1,000 person-year (95% CI = 15 to 22), while in females, it was 20 cases per 1,000 person-year (95% CI = 16 to 25). Leave-one-out analysis demonstrated that the incidence ranged from 21 to 28 cases per 1,000 person-year when excluding each study individually. Meta-regression analysis did not find a significant association between age and the risk of VTE (P = 0.079). Based on the included studies, risk factors of VTE in ALS patients included a history of VTE, non-invasive ventilation, immobility, and decreased functional status.
Patients with ALS face a higher risk of developing VTE compared to individuals of the same age. These findings underscore the importance of implementing preventive measures and closely monitoring VTE in ALS patients.
本系统评价和荟萃分析旨在确定肌萎缩侧索硬化症（ALS）患者静脉血栓栓塞症（VTE）的年发生率，并确定 VTE 的危险因素。
截至 2024 年 4 月 8 日，全面检索了三个数据库，以确定报告 ALS 患者 VTE 发生率的纵向研究。纳入的研究为前瞻性或回顾性研究，对 ALS 患者进行随访。使用 NIH 观察性队列研究工具进行质量评估。使用 Open Meta Analyst 进行荟萃分析，采用随机效应模型。还进行了亚组、Meta 回归和敏感性分析。
我们的分析包括 8 项研究，共纳入 26758 名符合纳入标准的 ALS 患者。所有研究中 VTE 的总年发生率为 22 例/1000 人年（95%CI=18 至 27）。亚组分析显示，男性 VTE 的年发生率为 19 例/1000 人年（95%CI=15 至 22），而女性为 20 例/1000 人年（95%CI=16 至 25）。逐一剔除研究的Leave-one-out 分析显示，当个别剔除每项研究时，发生率范围为 21 至 28 例/1000 人年。Meta 回归分析未发现年龄与 VTE 风险之间存在显著关联（P=0.079）。根据纳入的研究，ALS 患者 VTE 的危险因素包括 VTE 史、无创通气、活动受限和功能状态下降。
与同龄个体相比，ALS 患者发生 VTE 的风险更高。这些发现强调了在 ALS 患者中实施预防措施和密切监测 VTE 的重要性。
