High Absolute Risk and Predictors of Venous and Arterial Thromboembolic Events in Patients With Nephrotic Syndrome: Results from a Large Retrospective Cohort Study

Abstract Background Nephrotic syndrome is associated with an increased risk of venous thromboembolism (VTE). However, the risk factors of VTE in nephrotic syndrome, other than hypoalbuminemia and severe proteinuria, are not well established. Therefore we aimed to investigate the risk factors of VTE in patients with nephrotic syndrome. Methods This retrospective cohort study used data from a Japanese nationwide claims database. We identified patients ≥18 years of age hospitalized with nephrotic syndrome. Through multivariable logistic regression, we determined the risk factors of VTE in patients with nephrotic syndrome during hospitalization. Results Of the 7473 hospitalized patients with nephrotic syndrome without VTE, 221 (3.0%) developed VTE. In the VTE group, 14 (6.3%), 11 (5.0%) and 198 (89.6%) patients developed pulmonary embolism, renal vein thrombosis and deep vein thrombosis, respectively. We found that female sex {odds ratio [OR] 1.39 [95% confidence interval (CI) 1.05–1.85]}, body mass index (BMI) ≥30 [OR 2.01 (95% CI 1.35–2.99)], acute kidney injury [AKI; OR 1.67 (95% CI 1.07–2.62)], sepsis [OR 2.85 (95% CI 1.37–5.93)], lupus nephritis [OR 3.64 (95% CI 1.58–8.37)] and intravenous corticosteroids use [OR 2.40 (95% CI 1.52–3.80)] were associated with a significantly higher risk of developing VTE. Conclusions In patients with nephrotic syndrome, female sex, BMI ≥30, AKI, sepsis, lupus nephritis and intravenous corticosteroid use may help evaluate the risk of VTE.

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Older soft tissue sarcoma patients experience increased rates of venous thromboembolic events: a retrospective cohort study of SEER-Medicare data

Clinical Sarcoma Research ◽

10.1186/s13569-015-0033-z ◽

2015 ◽

Vol 5 (1) ◽

Cited By ~ 4

Author(s):

Sumitra Shantakumar ◽

Alexandra Connelly-Frost ◽

Monica G Kobayashi ◽

Robert Allis ◽

Li Li

Keyword(s):

Cohort Study ◽

Soft Tissue ◽

Soft Tissue Sarcoma ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Thromboembolic Events ◽

Medicare Data ◽

Venous Thromboembolic Events ◽

Venous Thromboembolic ◽

Patients Experience

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Risk of Nephrotic Syndrome following Enteroviral Infection in Children: A Nationwide Retrospective Cohort Study

PLoS ONE ◽

10.1371/journal.pone.0161004 ◽

2016 ◽

Vol 11 (8) ◽

pp. e0161004 ◽

Cited By ~ 4

Author(s):

Jiun-Nong Lin ◽

Cheng-Li Lin ◽

Chi-Hui Yang ◽

Ming-Chia Lin ◽

Chung-Hsu Lai ◽

...

Keyword(s):

Nephrotic Syndrome ◽

Cohort Study ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Enteroviral Infection

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Thromboembolic Rates Are Similar Between Intensive Care Unit and Nonintensive Care Unit Hospitalized Patients With Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2): A Retrospective Cohort Study

Clinical and Applied Thrombosis/Hemostasis ◽

10.1177/10760296211053315 ◽

2021 ◽

Vol 27 ◽

pp. 107602962110533

Author(s):

Heidi Worth ◽

Kasey Helmlinger ◽

Renju Raj ◽

Eric Heidel ◽

Ronald Lands

Keyword(s):

Intensive Care Unit ◽

Cohort Study ◽

Intensive Care ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Thromboembolic Event ◽

Hospitalized Patients ◽

Thromboembolic Events ◽

Icu Patients ◽

Increased Risk

High rates of thromboembolic events have been described in intensive care unit (ICU) patients. Data regarding thromboembolic events in all hospitalized patients has been less frequently reported, raising concerns that thromboembolic events in non-ICU may be underrecognized. In addition, optimal anticoagulation type and dose is still unsettled at this time. This is a retrospective cohort study of 159 hospitalized patients with coronavirus disease 2019 (COVID-19) pneumonia during a 9-month period to determine an association between the frequency of thromboembolic rates and hospitalized patients with COVID-19. Secondary outcomes sought to investigate association of thromboembolic events with relation to place of admission, risk factors, anticoagulation, mortality, hospital length of stay, and discharge disposition. Among the cohort of 159 hospitalized patients who met criteria, 16 (10%) were diagnosed with a thromboembolic event. There were a total of 18 thromboembolic events with 12 venous and 6 arterial. Admission to the ICU was not associated with a higher frequency of thromboembolic events compared with non-ICU patients (37.5% vs 62.5%), p = .71. Patients with a thromboembolic event had a significantly higher mortality compared with those with no thromboembolic event (37.5% vs 13.3%), p = .012. Patients hospitalized with COVID-19 have increased rates of thromboembolic events, both venous and arterial, which contribute to a significant increase in mortality. However, the frequency of thromboembolism in patients admitted to the ICU was similar to events in non-ICU patients. We hope to increase awareness of the increased risk of hypercoagulability in all hospitalized patients with COVID-19 including non-ICU patients.

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