与首次肺栓塞或深静脉血栓形成后的人口对照相比，时间趋势和过量死亡率

Time Trends and Excess Mortality Compared to Population Controls after a First-Time Pulmonary Embolism or Deep Vein Thrombosis

THROMBOSIS AND HAEMOSTASIS

影响因子:4.30000

分区:医学2区 Top / 血液学2区外周血管病2区

发表日期:2025 Apr

作者: Katarina Glise Sandblad, Carl Johan Svensson, Kristina Svennerholm, Jacob Philipson, Aldina Pivodic, Sam Schulman, Mazdak Tavoly

摘要

与普通人群相比，肺栓塞（PE）和深静脉血栓形成（DVT）患者过度死亡率的时间趋势的最新数据与普通人群相比稀少。2006年至2018年进行的全国瑞典登记册研究，包括68,960 PE和70,949个与人口控制匹配的DVT病例。泊松回归确定了30天和1年死亡率趋势的相对风险（RR），而Cox回归确定了调整后的危害比（AHR）。 A significance level of 0.001 was applied.In PE cases, both 30-day mortality (12.5% in 2006 to 7.8% in 2018, RR: 0.95 [95% CI: 0.95-0.96], p < 0.0001) and 1-year mortality (26.5 to 22.1%, RR: 0.98 [0.97-0.98], p < 0.0001) decreased during the study period.与对照组相比，30天（AHR：33.08 [95％CI：25.12-43.55]没有发生显着变化，至24.64 [95％CI：18.81-32.27]，与日历年的互动中的P = 0.0015，或1年级的互动）或1年（AHR：5.85 [95％CI：5.3％CI：5.31-6.45] 6.43-7.78]，p = 0.038）多余的死亡率。 The 30-day excess mortality decreased significantly (aHR: 39.93 [95% CI: 28.47-56.00) to 24.63 [95% CI: 17.94-33.83], p = 0.0009) in patients with PE without known cancer before baseline, while the excess 1-year mortality increased (aHR: 3.55 [95% CI: 3.16-3.99] to 5.38 [95% CI: 4.85-5.98]，p <0.0001）在PE病例中存活以填充抗凝处方。在DVT病例中，30天和1年的死亡率下降，而与对照组相比，过量死亡率仍然稳定。总的来说，PE和DVT后的死亡率提高了人口趋势。但是，没有癌症的PE病例降低了30天的死亡率过多，而生存以填充抗凝药物处方的人则显示出了过量的1年死亡率。这是Thieme在创意共享归因非商业许可证的条款上发表的一篇开放访问文章，只要给予原始工作适当的信用，就可以复制和复制。内容不得用于商业目的，或者改编，混合，转换或构建。（https://creativecommons.org/licenses/by-nc-nd/4.0/）。

Abstract

Recent data on temporal trends in excess mortality for patients with pulmonary embolism (PE) and deep vein thrombosis (DVT) compared with the general population are scarce.A nationwide Swedish register study conducted from 2006 to 2018 including 68,960 PE and 70,949 DVT cases matched with population controls. Poisson regression determined relative risk (RR) for 30-day and 1-year mortality trends while Cox regression determined adjusted hazard ratios (aHRs). A significance level of 0.001 was applied.In PE cases, both 30-day mortality (12.5% in 2006 to 7.8% in 2018, RR: 0.95 [95% CI: 0.95-0.96], p < 0.0001) and 1-year mortality (26.5 to 22.1%, RR: 0.98 [0.97-0.98], p < 0.0001) decreased during the study period. Compared with controls, no significant change was seen in 30-day (aHR: 33.08 [95% CI: 25.12-43.55] to 24.64 [95% CI: 18.81-32.27], p = 0.0015 for interaction with calendar year) or 1-year (aHR: 5.85 [95% CI: 5.31-6.45] to 7.07 [95% CI: 6.43-7.78], p = 0.038) excess mortality. The 30-day excess mortality decreased significantly (aHR: 39.93 [95% CI: 28.47-56.00) to 24.63 [95% CI: 17.94-33.83], p = 0.0009) in patients with PE without known cancer before baseline, while the excess 1-year mortality increased (aHR: 3.55 [95% CI: 3.16-3.99] to 5.38 [95% CI: 4.85-5.98], p < 0.0001) in PE cases surviving to fill a prescription of anticoagulation. In DVT cases, 30-day and 1-year mortality declined, while excess mortality compared with controls remained stable.In general, the improved mortality following PE and DVT paralleled population trends. However, PE cases without cancer had decreasing excess 30-day mortality, whereas those surviving to fill a prescription for anticoagulant medication showed increasing excess 1-year mortality.The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).