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炎症性肠病发作住院期间血栓栓塞的发生率及预测因素:台湾的一项回顾性队列研究

The Incidence and Predictive Factors of Thromboembolism During Hospitalizations for Inflammatory Bowel Disease Flare-Ups: A Retrospective Cohort Study in Taiwan.

作者信息

Meng Ming-Jung, Chung Chen-Shuan, Chang Chen-Wang, Pan Yu-Bin, Kuo Chia-Jung, Chiu Cheng-Tang, Le Puo-Hsien

机构信息

Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan.

Department of Internal Medicine, Division of Gastroenterology and Hepatology, Far Eastern Memorial Hospital, New Taipei City, Taiwan.

出版信息

J Eval Clin Pract. 2025 Sep;31(6):e14231. doi: 10.1111/jep.14231. Epub 2024 Nov 4.

Abstract

BACKGROUND/AIMS: Thromboembolism (TE) notably increase morbidity and mortality among inflammatory bowel disease (IBD) patients. Despite ECCO's 2024 guidelines advocating routine anticoagulant prophylaxis, its application in Asia remains inconsistent due to a lack of regional studies. This research investigates the incidence and predictors of TE during IBD-related hospitalizations in Taiwan, aiming to improve prevention strategies.

MATERIALS AND METHODS

Our retrospective cohort study included 282 adult IBD patients, accounting for 515 flare-up related hospitalizations at Linkou Chang Gung Memorial Hospital from January 2001 to March 2024. Patients were classified into two groups based on the occurrence of TE.

RESULTS

The incidence of TE was 1.55%. The TE group had significantly lower body weight, body mass index (BMI), hemoglobin and albumin levels but higher rate of sepsis and concurrent autoimmune diseases compared to the non-TE group. Multivariate analysis indicated that concurrent autoimmune diseases and hypoalbuminemia were independent predictors of TE. The optimal serum albumin cutoff was established at 3.01 g/dL, with sensitivities and specificities of 87.5% and 77.3%, respectively.

CONCLUSIONS

This pioneering Asian study identifies concurrent autoimmune diseases and low serum albumin as key predictors of TE in hospitalized IBD patients. We recommend targeted anticoagulant prophylaxis for IBD patients with these risk factors, especially when serum albumin falls below 3.01 g/dL.

摘要

背景/目的:血栓栓塞(TE)显著增加炎症性肠病(IBD)患者的发病率和死亡率。尽管欧洲克罗恩病和结肠炎组织(ECCO)2024年指南提倡常规抗凝预防,但由于缺乏区域研究,其在亚洲的应用仍不一致。本研究调查台湾IBD相关住院期间TE的发病率及预测因素,旨在改进预防策略。

材料与方法

我们的回顾性队列研究纳入了282例成年IBD患者,这些患者在2001年1月至2024年3月期间于林口长庚纪念医院因病情发作住院515次。根据TE的发生情况将患者分为两组。

结果

TE的发病率为1.55%。与非TE组相比,TE组患者的体重、体重指数(BMI)、血红蛋白和白蛋白水平显著更低,但败血症和并发自身免疫性疾病的发生率更高。多因素分析表明,并发自身免疫性疾病和低白蛋白血症是TE的独立预测因素。最佳血清白蛋白临界值确定为3.01 g/dL,敏感性和特异性分别为87.5%和77.3%。

结论

这项开创性的亚洲研究确定并发自身免疫性疾病和低血清白蛋白是住院IBD患者发生TE的关键预测因素。我们建议对有这些危险因素的IBD患者进行有针对性的抗凝预防,尤其是当血清白蛋白低于3.01 g/dL时。

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