COVID-19患者静脉血栓栓塞的影响因素

IF 0.2 Q4 PHARMACOLOGY & PHARMACY Asian Journal of Pharmaceutical Research and Health Care Pub Date : 2023-01-01 DOI:10.4103/ajprhc.ajprhc_13_23
L. P. Low, F. Islahudin, S. Saffian
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引用次数: 0

摘要

背景:抗凝剂用于预防和治疗2019冠状病毒病的静脉血栓栓塞(VTE),如深静脉血栓形成(DVT)和肺栓塞(PE),以获得更好的结果。目的:探讨COVID-19患者静脉血栓栓塞的临床结局及影响因素。环境与设计:研究设计为回顾性队列研究。研究方法:纳入某三级医院使用皮下抗凝剂的住院COVID-19患者。统计分析方法:采用多元logistic回归分析确定影响受试者静脉血栓栓塞的因素。结果:共纳入450例患者。抗凝剂类型包括氟达肝素(n = 114, 38.1%)、依诺肝素(n = 113, 37.8%)和肝素(n = 72, 24.1%)。423例(94.0%)出院,27例(6.0%)进入重症监护病房(ICU)。主要结果是静脉血栓栓塞的发生率,发生在19.3% (n = 87)例患者中,其中80例(92.0%)报告DVT, 7例(8.0%)报告PE。次要终点平均住院时间为9.9(±4.7)天。未使用SC抗凝药物的患者与使用SC抗凝药物的患者相比,发生静脉血栓栓塞的因素更有可能(调整优势比[aOR] 54.330, 95%可信区间[CI]: 7.086, 416.526),使用fondaparinux治疗的患者与使用肝素治疗的患者相比(aOR: 2.502, 95% CI: 1.175, 5.327),出院良好的患者与ICU患者相比发生静脉血栓栓塞的因素更低(aOR: 0.139, 95% CI: 0.053, 0.361)。结论:需要仔细监测以降低COVID-19患者的静脉血栓栓塞风险。
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Factors of venous thromboembolism among COVID-19 patients
Context: Anticoagulants are used to prevent and treat venous thromboembolism (VTE), such as deep-vein thrombosis (DVT) and pulmonary embolism (PE) in COVID-19 for better outcomes. Aim: This study aims to explore clinical outcomes and factors affecting VTE among COVID-19 patients. Settings and Design: The study design involved a retrospective cohort study. Study Methods: Hospitalized COVID-19 patients in a tertiary hospital prescribed subcutaneous (SC) anticoagulants were included. Statistical Analysis Used: Multiple logistic regression was performed to determine factors affecting VTE among subjects. Results: A total of 450 patients were included. Types of anticoagulants include fondaparinux (n = 114, 38.1%), enoxaparin (n = 113, 37.8%), and heparin (n = 72, 24.1%). 423 (94.0%) patients were discharged well, 27 (6.0%) patients were admitted to the intensive care unit (ICU). The primary outcome was the prevalence of VTE, which occurred in 19.3% (n = 87) patients, with 80 (92.0%) reporting DVT and 7 (8.0%) reporting PE. The secondary outcome, which was the average length of hospital stay was 9.9 (±4.7) days. Factors of VTE occurrence were likely in patients not prescribed SC anticoagulants compared to those prescribed with SC anticoagulants (adjusted odds ratio [aOR] 54.330, 95% confidence interval [CI]: 7.086, 416.526), treatment with fondaparinux compared to heparin (aOR 2.502, 95% CI: 1.175, 5.327), and less likely in those discharged well compared to patients in the ICU (aOR 0.139, 95% CI: 0.053, 0.361). Conclusions: Careful monitoring is required to reduce VTE risk in COVID-19 patients.
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