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胸腔积液是社区获得性肺炎住院患者发生静脉血栓栓塞症的危险因素:一项回顾性队列研究。

Parapneumonic effusion is a risk factor for VTE in hospitalized patients with community-acquired pneumonia: a retrospective cohort study.

作者信息

Shi Xin-Yu, Zhang Yi-Xiao, Yi Feng-Shuang, Dong Shu-Feng, Chen Qing-Yu, Jiao Xiao-Jing, Yang Yuan-Hua

机构信息

Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chao- Yang Hospital, Capital Medical University, 8 Gongti Nanlu, Chao-Yang District, Beijing, 100020, China.

出版信息

Thromb J. 2025 Feb 10;23(1):11. doi: 10.1186/s12959-025-00687-y.

Abstract

BACKGROUND

Venous thromboembolism (VTE) is a major, frequent, and potentially fatal health issue worldwide. Community-acquired pneumonia (CAP) is one of the leading causes of hospitalization and parapneumonic pleural effusion (PPE) is a relatively common complication of pneumonia. Whether PPE is a risk factor for VTE in hospitalized patients with CAP has not been studied before.

METHODS

We retrospectively reviewed all patients diagnosed with CAP admitted to our center from 1 January to 31 August in 2019. The clinical and laboratory data were collected from medical records. Univariate and multivariable logistic regression analysis were used to assess the VTE related risk factors. Subgroup analysis was conducted to investigate the potential correlation between PPE and VTE among distinct subsets of hospitalized patients diagnosed with CAP.

RESULTS

This retrospective cohort study included 703 inpatients and 73 patients were confirmed VTE. In multivariable logistic regression analysis, PPE, age, sex, gender, D-dimer, and pneumonia severity index score, were significantly correlated with VTE. Several laboratory parameters within the PPE group demonstrated significant elevated levels compared to the non-PPE cohort, encompassing inflammatory markers such as neutrophils, C reaction protein, D-dimer, as well as some coagulation indicators including platelets, and prothrombin time.

CONCLUSION

PPE is an independent risk factor for hospitalized CAP patients. The patients with PPE have a higher level of inflammation response. Medical clinicians should pay more attention to VTE and improve its prevention and therapeutic strategies among hospitalized CAP patients.

摘要

背景

静脉血栓栓塞症(VTE)是全球范围内一个主要的、常见的且可能致命的健康问题。社区获得性肺炎(CAP)是住院的主要原因之一,而肺炎旁胸腔积液(PPE)是肺炎相对常见的并发症。此前尚未研究过PPE是否为住院CAP患者发生VTE的危险因素。

方法

我们回顾性分析了2019年1月1日至8月31日期间入住本中心并诊断为CAP的所有患者。从病历中收集临床和实验室数据。采用单因素和多因素逻辑回归分析评估与VTE相关的危险因素。进行亚组分析以研究在诊断为CAP的住院患者不同亚组中PPE与VTE之间的潜在相关性。

结果

这项回顾性队列研究纳入了703名住院患者,其中73例确诊为VTE。在多因素逻辑回归分析中,PPE、年龄、性别、D-二聚体和肺炎严重程度指数评分与VTE显著相关。与非PPE队列相比,PPE组的几个实验室参数显示出显著升高,包括炎症标志物如中性粒细胞、C反应蛋白、D-二聚体,以及一些凝血指标如血小板和凝血酶原时间。

结论

PPE是住院CAP患者的独立危险因素。患有PPE的患者炎症反应水平更高。临床医生应更加关注住院CAP患者的VTE,并改进其预防和治疗策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9505/11809021/c7bdfda9b776/12959_2025_687_Fig2_HTML.jpg

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