费城阴性骨髓增生性肿瘤患者静脉血栓栓塞相关入院的趋势和住院结果

Vatsala Katiyar, Alok Uprety, A. Mendez-Hernandez, H. Fuentes, X. A. Andrade, M. Zia
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引用次数: 3

摘要

费城阴性骨髓增生性肿瘤(mpn)患者,包括真性红细胞增多症(PV)、原发性血小板增多症(ET)和原发性骨髓纤维化(MF),具有显著的静脉血栓栓塞(VTE)风险。我们的目的是确定静脉血栓栓塞相关的年住院率、相关费用、住院时间(LOS)和MPN患者的住院死亡率的趋势。方法采用ICD-9CM编码对2006 - 2014年全国住院患者样本(NIS)数据库中PV、ET和MF患者进行鉴定。静脉血栓栓塞在前三名诊断中的住院被认为与静脉血栓栓塞有关。我们使用卡方检验和Mann-Whitney u检验比较静脉血栓栓塞和非静脉血栓栓塞住院患者的住院结果,并使用线性回归进行趋势分析。结果我们确定了1,046,666例诊断为MPN的入院患者。患者以白人(65.6%)为主,女性(52.7%),中位年龄66岁(范围:18-108岁)。主要的MPN为ET(54%)。两组间住院死亡率无差异(静脉血栓栓塞:3.4% vs.非静脉血栓栓塞:3.2%;p = 0.12);然而,静脉血栓栓塞患者的LOS较长(中位数:6天vs. 5天;p < 0.01)和更高的成本(VTE中位数:32,239美元vs. 28,403美元;P≤0.01)。VTE的年录取率随着时间的推移而下降(2006年:3.94%,2014年:2.43%;p≤0.01),与非vte相关入院相比。结论:在我们的研究中,与vte相关的住院患者与非vte相关的住院患者相比具有相似的住院死亡率。静脉血栓栓塞的住院率随着时间的推移而下降,但与较高的费用和LOS相关。较新的风险评估工具可能有助于预防高危患者静脉血栓栓塞和优化资源利用。
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Trends and Inpatient Outcomes of Venous Thromboembolism-Related Admissions in Patients with Philadelphia-Negative Myeloproliferative Neoplasms
Abstract Background Patients with Philadelphia-negative myeloproliferative neoplasms (MPNs), including polycythemia vera (PV), essential thrombocytosis (ET), and primary myelofibrosis (MF), have a significant risk of venous thromboembolism (VTE). We aim to determine the trends in annual rates of VTE-related admissions, associated cost, length of stay (LOS), and in-hospital mortality in patients with MPN. Methods We identified patients with PV, ET, and MF from the Nationwide Inpatient Sample (NIS) database from 2006 to 2014 using ICD-9CM coding. Hospitalizations where VTE was among the top-three diagnoses were considered VTE-related. We compared in-hospital outcomes between VTE and non-VTE hospitalizations using chi-square and Mann–Whitney U-test and used linear regression for trend analysis. Results We identified 1,046,666 admissions with a diagnosis of MPN. Patients were predominantly white (65.6%), females (52.7%), with a median age of 66 years (range: 18–108). The predominant MPN was ET (54%). There was no difference in in-hospital mortality between groups (VTE: 3.4% vs. non-VTE: 3.2%; p = 0.12); however, VTE admissions had a longer LOS (median: 6 vs. 5 days; p < 0.01) and higher cost (median: VTE US$32,239 vs. 28,403; p ≤ 0.01). The annual rate of VTE admissions decreased over time (2006: 3.94% vs. 2014: 2.43%; p ≤ 0.01), compared with non-VTE–related admissions. Conclusion In our study, VTE-related admissions had similar in-hospital mortality as compared with non-VTE–related admissions. The rates of hospitalizations due to VTE have decreased over time but are associated with a higher cost and LOS. Newer risk assessment tools may assist in preventing VTE in high-risk patients and optimizing resource utilization.
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