静脉血栓栓塞后3和12个月的功能限制：一项队列研究
Functional limitations 3 and 12 months after venous thromboembolism: a cohort study
影响因子:3.40000
分区:医学3区 / 血液学3区 外周血管病3区
发表日期:2024 May
作者:
Daniel Steiner, Stephan Nopp, Georg Heinze, Daniel Kraemmer, Oliver Schlager, Stefano Barco, Frederikus A Klok, Ingrid Pabinger, Benedikt Weber, Cihan Ay
摘要
静脉血栓栓塞（VTE）与各种长期并发症有关。我们旨在调查VTE诊断时临床特征与功能限制的关联3和12个月。我们对VTE患者进行了前瞻性队列研究，不包括患者，癌症，妊娠和产后期。在诊断后的21天内，3和12个月后（前瞻性）和诊断前的1个月（回顾性），用VTE后功能状态（PVFS）量表（范围为0-4）评估功能局限性。仅在抗凝患者中进行了十二个月的随访。 We fitted 2 proportional odds logistic regression models for the 3- and 12-month follow-ups and computed odds ratios (ORs) with 95% bootstrap percentile confidence intervals (CIs).We included 307 patients (42% female, median age 55.6 years) with a median (IQR) PVFS scale grade of 2 (2-3) at study inclusion and 0 (0-0) before diagnosis. 3个月后，269例患者的PVFS量表成绩为1（0-2）。女性（OR，2.15; 95％CI，1.26-4.14），体重指数（或每1 kg/m2升高，1.05； 95％CI，1.00-1.10），基线时的功能限制和较老的年龄与功能限制有关。 12个月后，124例患者的PVFS量表成绩为1（0-2）。女性（OR，4.47; 95％CI，2.11-16.00），心血管/肺部疾病的历史（OR，2.36; 95％CI，1.01-6.89），基线时的功能限制与功能限制有关。VTE患者的诊断后3和12个月的功能限制没有恢复诊断后的功能限制。我们确定了临床特征，可以帮助识别有VTE后持续存在功能限制的患者。
Abstract
Venous thromboembolism (VTE) is associated with various long-term complications.We aimed to investigate the association of clinical characteristics at VTE diagnosis with functional limitations 3 and 12 months afterward.We conducted a prospective cohort study of VTE patients, excluding patients with cancer, pregnancy, and postpartum period. Functional limitations were assessed with the post-VTE functional status (PVFS) scale (range, 0-4) within 21 days of diagnosis, after 3 and 12 months (prospectively), and 1 month before diagnosis (retrospectively). Twelve-month follow-up was only performed in patients on anticoagulation. We fitted 2 proportional odds logistic regression models for the 3- and 12-month follow-ups and computed odds ratios (ORs) with 95% bootstrap percentile confidence intervals (CIs).We included 307 patients (42% female, median age 55.6 years) with a median (IQR) PVFS scale grade of 2 (2-3) at study inclusion and 0 (0-0) before diagnosis. After 3 months, PVFS scale grade in 269 patients was 1 (0-2). Female sex (OR, 2.15; 95% CI, 1.26-4.14), body mass index (OR per 1 kg/m2 increase, 1.05; 95% CI, 1.00-1.10), functional limitations at baseline, and older age were associated with functional limitations. After 12 months, PVFS scale grade in 124 patients was 1 (0-2). Female sex (OR, 4.47; 95% CI, 2.11-16.00), history of cardiovascular/pulmonary disease (OR, 2.36; 95% CI, 1.01-6.89), and functional limitations at baseline were associated with functional limitations.Functional limitations in VTE patients improved 3 and 12 months after diagnosis but did not return to pre-VTE values. We identified clinical characteristics that could help identify patients at risk of persisting functional limitations after VTE.