scholarly journals Covid-19 Disease Is Not Associated with Venous Thromboembolism in a Cohort of Patients in Jeddah, Saudi Arabia

Blood ◽  
2020 ◽  
Vol 136 (Supplement 1) ◽  
pp. 24-24
Author(s):  
Fatemah Kamel ◽  
Rania Magadmi ◽  
Sulafa Alqutub ◽  
Maha A. Badawi ◽  
Fatin Al-Sayes ◽  
...  
Keyword(s):  
Risk Factors ◽  
Saudi Arabia ◽  
Venous Thromboembolism ◽  
Conflicts Of Interest ◽  
Demographic Data ◽  
White Blood Cells ◽  
Gastrointestinal Symptoms ◽  
University Hospital ◽  
Retrospective Case ◽  
D Dimer

Background: Coronavirus disease 2019 (COVID-19) caused by acute respiratory syndrome coronavirus 2 (SARS2), is associated with significant morbidity and mortality. The aim of this study is to characterize risk factors and clinical features of COVID-19 disease in an adult cohort in Jeddah, Saudi Arabia. Methods: A retrospective case control study was conducted at King Abdulaziz University hospital (KAUH) in Jeddah, Saudi Arabia. Clinical and demographic data on patients presenting at KAUH with concern for COVID-19 disease between March 18 and May 18, 2020 were collected and analyzed. Results: Electronic medical records on 297 patients presenting at KAUH were reviewed. Of these, 175 (59%) tested positive for COVID-19 by polymerase chain reaction (PCR) and 122 (41%) tested negative. COVID-19 positive patients were more likely to be males (OR=1.59; 95% CI=1.22-2.07), and non-health care workers (OR=1.53; 95% CI=1.13-2.08). Hypertension (10%), diabetes (10%), and two or more concurrent co-morbid conditions (54.4%), were more prevalent among COVID-19 positive patients. Patients presenting with fever, cough, and loss of sense of taste or smell were more likely to test positive for COVID-19 (p=0.001, 0.008, 0.008, respectively. Radiological evidence of pneumonia was associated with confirmed COVID-19 disease. Dyspnea, cough and gastrointestinal symptoms were not associated with risk of COVID-19 at presentation. On admission, white blood cells, neutrophils, lymphocytes, eosinophils, basophils, and platelets were significantly lower among COVID-19 positive patients compared to controls. Surprisingly, D-dimer levels were lower among COVID-19 positive patients. Furthermore, only two patients developed thrombosis; one with pulmonary embolism and one with coronary artery thrombosis. Conclusion: Male gender, hypertension and diabetes were associated with risk of COVID-19 disease in this study population. D-dimer levels were not elevated in COVID-19 patients, and venous thromboembolism was not prevalent in cases, compared to controls. This is in contrast to previous reports on the association of COVID-19 disease with venous thromboembolism in other populations. Thus, individual and environmental risk factors may play an important role in the pathophysiology of thrombosis in COVID-19 disease. Disclosures No relevant conflicts of interest to declare.

scholarly journals D-Dimer Levels and Risk of Recurrence Following Provoked Venous Thromboembolism: Findings from the Riete Registry

Blood ◽  
2018 ◽  
Vol 132 (Supplement 1) ◽  
pp. 3810-3810
Author(s):  
Martin Ellis ◽  
Martin Mar ◽  
Monreal Manuel ◽  
Orly Hamburger-Avnery ◽  
Alessandra Bura-Riviere ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Venous Thromboembolism ◽  
Anticoagulant Therapy ◽  
Conflicts Of Interest ◽  
Hazard Ratio ◽  
Increased Risk ◽  
Risk Patients ◽  
Recurrent Vte ◽  
D Dimer

Abstract Background. Patients with venous thromboembolism (VTE) secondary to transient risk factors or cancer may develop VTE recurrences after discontinuing anticoagulant therapy. Identifying at-risk patients could help to guide the ideal duration of anticoagulant therapy in these patients. Methods. We used the RIETE database to assess the prognostic value of d-dimer testing after discontinuing anticoagulation to identify patients at increased risk for recurrences. The proportion of patients with raised d-dimer levels was determined and the hazard ratio (HR) for VTE recurrences compared to those with normal levels was calculated. Univariate and multivariate analyses of factors associated with VTE recurrence were performed. Results. 3 606 patients were identified in the database in April 2018: 2 590 had VTE after a transient risk factor and 1016 had a cancer. D-dimer levels were measured after discontinuing anticoagulation in 1 732 (67%) patients with transient risk factors and 732 (72%) patients with cancer-associated VTE and these patients formed the cohort in which recurrent VTE rate was calculated. D-dimers and were elevated in 551 (31.8%) of patients with a transient risk factor and were normal in 1181 (68.2%). In the cancer-associated group, d-dimers were elevated in 398 (54.3%) and normal in 334 (45.7%) patients. The adjusted hazard ratio for recurrent VTE was: 2.32 (95%CI: 1.55-3.49) in patients with transient risk factors and 2.23 (95%CI: 1.50-3.39) in those with cancer. Conclusions. Patients with raised d-dimer levels after discontinuing anticoagulant therapy for provoked or cancer-associated VTE are at increased risk for recurrent VTE and death. Future studies could target these patients for extended anticoagulation. Disclosures No relevant conflicts of interest to declare.

Association Study of Microrna and Microrna-Biogenesis Gene Polymorphisms with Venous Thromboembolism (VTE) in Korean Population

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 3395-3395
Author(s):  
Nam Keun Kim ◽  
Young Joo Jeon ◽  
Moon Ju Jang ◽  
Doyeun Oh
Keyword(s):  
Risk Factors ◽  
Venous Thromboembolism ◽  
Gene Polymorphisms ◽  
Conflicts Of Interest ◽  
Medical Center ◽  
Statistical Significance ◽  
University Hospital ◽  
Health Concern ◽  
Control Group ◽  
Microrna Biogenesis

Abstract Abstract 3395 Venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE), represents a public health concern in Western and Asian countries. Venous thromboembolism often complicates the course of hospitalized patients but may also affect ambulatory and otherwise healthy people. The classic risk factors for VTE are cancer, surgery, prolonged immobilization, fracture, paralysis, oral contraceptive use, and hereditary coagulopathies. In addition to these classic risk factors, microparticle containing microRNA is a known risk factor for both arterial and venous thrombosis. The aim of study was to investigate genetic association between microRNAs or microRNA-biogenesis genes and VTE. We selected 6 well-studied polymorphisms of miR-146a (rs2910164), miR-196a2 (rs11614913), miR-499 (rs3746444), DICER (rs3742330), DROSHA (rs10719), and RAN (rs14035). Patients with consecutive VTE with recent (<6 months) objective diagnosis of DVT or PE, who visited to the CHA Bundang Medical Center (Seongnam, Korea) or Keimyung University hospital (Daegu, Korea) between May 2005 and December 2009, were enrolled in the study. We enrolled the patients with symptomatic VTE and excluded the patients with asymptomatic VTE. Venous thromboembolism was defined as provoked or unprovoked, depending on the presence or absence of any of the following risk factors: recent surgery (<3 months), recent trauma/fracture (<3 months), immobilization (>7 days), malignancy, stroke, severe medical disease, autoimmune disease, pregnancy, use of oral contraceptives, and known inherited thrombophilia. Venous thromboembolism was classified as provoked in the presence of at least one of these risk factors. The control group was selected among patients visiting the CHA Bundang Health Promotion Center for periodic health examinations, who had no medical history of VTE. The Institutional Review Board of CHA Bundang Medical Center approved the research protocol and written informed consent was obtained from all participating individuals. Genotyping of microRNA and microRNA-biogenesis gene polymorphisms was performed by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) assay. Multivariate logistic regression was used to calculate strength of association. The genetic distributions of microRNA and microRNA-biogenesis gene polymorphisms were in Hardy-Weinberg equilibrium (Table 1). RAN rs14035 CC genotype was associated with increased VTE risk (adjusted odds ratio [AOR], 1.640; 95% confidence interval [CI], 1.106–2.432; P=0.014; Table 1). The statistical significance of RAN rs14035 CC was strengthened in unprovoked VTE patients (AOR, 2.478; 95% CI, 1.410–4.357; P=0.002; Table 2). Although other microRNA-related polymorphisms showed differences between controls and VTE patients, there were not positive statistical significances. In conclusion, RAN rs14035 CC may be a possible predisposing factor for VTE development. Disclosures: No relevant conflicts of interest to declare.

Pressure ulcer incidence in acute care settings: a multicentre prospective study

2021 ◽  
Vol 30 (11) ◽  
pp. 930-938
Author(s):  
Ma'en Aljezawi
Keyword(s):  
Risk Factors ◽  
Acute Care ◽  
Pressure Ulcer ◽  
Conflicts Of Interest ◽  
White Blood Cells ◽  
Albumin Level ◽  
Advisory Panel ◽  
Hospitalised Patients ◽  
Acute Care Settings ◽  
Associated Risk Factors

Objective: Pressure ulcers (PUs) are one of the most commonly occurring complications in hospitalised patients. Knowing the size of the problem and its risk factors will help in preventing it. The aim of this study is to measure the incidence of PUs in acute care settings in Jordan and to explore associated risk factors. Method: A prospective incidence study for hospitalised patients in Jordan according to the European Pressure Ulcer Advisory Panel methodology. All patients admitted into four Jordanian hospitals over a period of six months were included. Results: The cumulative incidence rate was 0.48%. Using multivariate analysis, a low albumin level, elevated white blood cells, incontinence and having more chronic illnesses were significantly associated with acquiring PUs. Conclusion: Incidence of PUs in Jordan is lower when compared with other parts of the world; this could be related to the relatively younger Jordanian population compared with other populations. Declaration of interest: The author has no conflicts of interest to declare.

scholarly journals Risk factors for mortality among inpatients with smear positive pulmonary tuberculosis

2019 ◽  
Vol 35 (5) ◽  
Author(s):  
Sidra Hameed ◽  
Faisal Faiyaz Zuberi ◽  
Sagheer Hussain ◽  
Syed Khalid Ali
Keyword(s):  
Risk Factors ◽  
Pulmonary Tuberculosis ◽  
Demographic Data ◽  
Sampling Technique ◽  
Cross Sectional Study ◽  
University Hospital ◽  
Smoking History ◽  
Cross Sectional ◽  
Creative Commons ◽  
Smear Positive Pulmonary Tuberculosis

Objective: To evaluate risk factors having significant effect on mortality of smear positive Pulmonary Tuberculosis (PTB) inpatients. Methods: A descriptive cross-sectional study was conducted at Ojha Institute of Chest Diseases, Dow University Hospital Ojha Campus, Karachi. One hundred and seventy (170) inpatients of smear positive PTB confirmed by Acid Fast Bacilli (AFB) smear, aged between 13-80 years were enrolled by using consecutive sampling technique while patients with drug resistant Tuberculosis (TB) and extra pulmonary TB were excluded from the study. Selected patients were interviewed for collecting demographic data and risk factor data by using a standard questionnaire. Results: Out of 170 PTB inpatients, mortality was observed in 23 (13.5%) patients among which male patients were 12 (52.2%), and female were 11 (47.8%). Mortality was significantly associated with increasing age (p=0.003), socioeconomic status (p=0.019), anemia (p=0.03), Chronic Liver Disease (CLD) (p=0.005), Diabetes Mellitus (DM) (p=0.001), Human Immunodeficiency Virus (HIV) (p=0.007), Hypertension (HTN) (p=0.006), recurrent TB (p=0.001), and smoking (p=0.001). Conclusion: Increasing age, poverty, smoking history, and presence of comorbidities like DM, CLD, HIV, hypertension, and anemia are associated with higher mortality in smear positive PTB cases. doi: https://doi.org/10.12669/pjms.35.5.919 How to cite this:Hameed S, Zuberi FF, Hussain S, Ali SK. Risk factors for mortality among inpatients with smear positive pulmonary tuberculosis. Pak J Med Sci. 2019;35(5):---------. doi: https://doi.org/10.12669/pjms.35.5.919 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Venous Thromboembolism in Patients With Thrombocytopenia: Risk Factors, Treatment, and Outcome

2015 ◽  
Vol 23 (4) ◽  
pp. 345-350 ◽  
Author(s):  
Jens Kristian Baelum ◽  
Espen Ellingsen Moe ◽  
Mads Nybo ◽  
Pernille Just Vinholt
Keyword(s):  
Risk Factors ◽  
Platelet Count ◽  
Venous Thromboembolism ◽  
Blood Cells ◽  
Medical Records ◽  
Odds Ratio ◽  
Conditional Logistic Regression ◽  
University Hospital ◽  
Hospital Department ◽  
Bleeding Episodes

Background: Venous thromboembolism (VTE) is a frequent and potentially lethal condition. Venous thrombi are mainly constituted of fibrin and red blood cells, but platelets also play an important role in VTE formation. Information about VTE in patients with thrombocytopenia is, however, missing. Objectives: To identify VTE risk factors and describe treatment and outcome (bleeding episodes and mortality) in patients with thrombocytopenia. Patients/Methods: Patients with thrombocytopenia (platelet count <100 × 109/L) admitted to Odense University Hospital, Denmark, between April 2000 and April 2012 were included. Fifty cases had experienced VTE. Controls without VTE were matched 3:1 with cases on sex and hospital department. Medical records were examined, and data were analyzed using conditional logistic regression. Results: In multivariate analysis, platelet count <50 × 109/L (odds ratio [OR] 0.22, P < .05) and chronic liver disease (OR 0.05, 95% confidence interval [CI] 0.01-0.58) reduced the risk of VTE. Surgery (OR 6.44, 95% CI 1.37-30.20) and previous thromboembolism (OR 6.16, 95% CI 1.21-31.41) were associated with an increased VTE risk. Ninety-two percent of cases were treated with anticoagulants. There was no difference in bleeding incidence between cases and controls. Conclusions: Several known VTE risk factors also seems to apply in patients with thrombocytopenia. Also, patients with thrombocytopenia may be VTE risk stratified based on platelet count and comorbidities. Finally, patients having thrombocytopenia with VTE seem to be safely treated with anticoagulants without increased occurrence of bleeding.

Venous Thromboembolism

2020 ◽  
Author(s):  
Samuel Z. Goldhaber
Keyword(s):  
Risk Factors ◽  
Pulmonary Embolism ◽  
Venous Thromboembolism ◽  
Venous Thrombosis ◽  
Antithrombotic Agents ◽  
Vein Thrombosis ◽  
Recurrent Venous Thrombosis ◽  
Deep Vein ◽  
D Dimer ◽  
In Pregnancy

Venous thromboembolism, which involves venous thrombosis and pulmonary embolism, is a leading cause of morbidity and mortality in hospitalized patients and is being seen with increasing frequency in outpatients. This chapter discusses the risk factors, etiology, classification, pathophysiology, natural history, prognosis, diagnosis (including venous thrombosis, recurrent venous thrombosis, and pulmonary embolism), prophylaxis, and treatment of venous thromboembolism (including the pharmacology of antithrombotic agents), as well as venous thromboembolism in pregnancy and miscellaneous thromboembolic disorders (including thrombosis of unusual sites).  This review contains 8 figures, 16 tables, and 79 references. Keywords: Venous thromboembolism, pulmonary embolism, deep vein thrombosis, embolectomy, thrombolysis, hypercoagulability, duplex ultrasonography, D-dimer, anticoagulation

Risk factors for venous thromboembolism in patients with diabetes undergoing joint arthroplasty

2020 ◽  
Author(s):  
Wei Deng ◽  
Lili Huo ◽  
Qiang Yuan ◽  
Deyong Huang ◽  
Quan Li ◽  
...  
Keyword(s):  
Risk Factors ◽  
Venous Thromboembolism ◽  
Protective Role ◽  
Pulmonary Angiography ◽  
Joint Arthroplasty ◽  
Multivariate Logistic Regression Model ◽  
Mechanical Prophylaxis ◽  
Patients With Diabetes ◽  
High Level ◽  
D Dimer

Abstract Background: Venous thromboembolism (VTE) is a significant complication after joint arthroplasty. Diabetes is related to a few changes in coagulation and fibrinolysis that may lead to thrombophilia. We aim to investigate the incidence of and risk factors for VTEs in patients with diabetes undergoing total hip (THA) or total knee anthroplasty (TKA) in a single centre in China. Methods: Patients with diabetes who underwent THA or TKA from January 2016 to December 2018 (n=400) at Beijing Jishuitan Hospital were recruited in this study. Lower limb venous Doppler ultrasound was performed before and after surgery to confirm deep venous thrombosis (DVT). Computer tomography pulmonary angiography was done to confirm pulmonary embolism (PE) for those with new postoperative DVT and typical symptoms of PE. A multivariate logistic regression model was conducted to examine factors associated with the development of postoperative VTE. Results: The overall incidence of postoperative VTE in patients with diabetes after THA or TKA was 46.8% (187 of 400). Female patients and patients undergoing TKA had higher incidence of postoperative VTE. Patients who developed postoperative VTE were older, and had higher levels of preoperative D-Dimer level and Caprini score. Increased VTE risks were associated with high level of preoperative D-Dimer (OR=2.11, 95%CI=1.35-3.30) and TKA (OR=2.29, 95%CI=1.29-4.01). Postoperative initiation of concomitant mechanical prophylaxis and low molecular weight heparin (LMWH) was protective for postoperative DVT (OR=0.56, 95%CI=0.37-0.86). Conclusions: VTE is common in patients with diabetes undergoing joint arthroplasty. Patients undergoing TKA or with a high level of preoperative D-Dimer are at a considerable risk of developing postoperative VTE. There may be a protective role of postoperative initiation of concomitant mechanical prophylaxis and LMWH for VTE.

The Prevalence and Relationship between Periodontal Disease and Pre-term Low Birth Weight Infants at King Khalid University Hospital in Riyadh, Saudi Arabia

2004 ◽  
Vol 5 (2) ◽  
pp. 40-56 ◽  
Author(s):  
Sameer Abdullah Mokeem ◽  
Ghadeer Nabeel Molla ◽  
Thikriat Saleh Al-Jewair
Keyword(s):  
Risk Factors ◽  
Saudi Arabia ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Periodontal Disease ◽  
University Hospital ◽  
Low Birth Weight Infants ◽  
Study Population ◽  
Associated Risk Factors ◽  
Periodontal Indices

Abstract The aim of this study was to examine the prevalence and relationship between periodontal disease and preterm low birth weight (PLBW) among Saudi mothers at King Khalid University Hospital (KKUH) in Riyadh, Saudi Arabia. The periodontal status and the relative risk were also analyzed. The study consisted of 30 cases [infants <37 weeks and/or weighing ≥2.500 kilograms (kg)] and a daily random sample of 60 controls [≥37 weeks and/or weighing >2.500 kg]. Clinical periodontal indices were measured on the labor wards. Associated risk factors for periodontal disease and PLBW were ascertained by means of a structured questionnaire and maternal notes. The prevalence of the PLBW was found to be 11.3%, and the prevalence of periodontal disease was high among the study population. The risk of PLBW remained high with increasing periodontal disease (odds ratio [OR] 4.21, 95% confident interval [CI] 1.99-8.93) despite controlling the other risk factors such as age, smoking, and social class. In conclusion, there is a correlation between periodontal disease and PLBW in KKUH. Citation Mokeem SA, Molla GN, Al-Jewair TS. The Prevalence and Relationship between Periodontal Disease and Pre-term Low Birth Weight Infants at King Khalid University Hospital in Riyadh, Saudi Arabia. J Contemp Dent Pract 2004 May;(5)2:040-056.

The Low-Molecular-Weight-Heparin, Tinzaparin, Is Effective and Safe in the Treatment and Prophylaxis of Venous Thromboembolic Disease during Pregnancy.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 1774-1774 ◽  
Author(s):  
Maja Jorgensen ◽  
Jorn D. Nielsen
Keyword(s):  
Risk Factors ◽  
Molecular Weight ◽  
Venous Thromboembolism ◽  
High Risk ◽  
Pregnant Women ◽  
University Hospital ◽  
Individual Risk ◽  
Low Molecular Weight ◽  
Venous Thromboembolic ◽  
Individual Risk Assessment

Abstract During pregnancy the incidence of venous thromboembolism (VTE) is approximately 6 times higher than in age-matched, non-pregnant women and venous thromboembolism remains the most common cause of maternal morbidity and mortality. Low-molecular-weight-heparins are recommended for treatment of VTE during pregnancy and for prophylaxis of VTE in pregnant women with major thromboembolic risk factors. We used tinzaparin for prophylaxis and treatment of VTE in 305 consecutive pregnant women referred to the Thrombosis Centre, Gentofte University Hospital, from 1997 to 2004. In 268 pregnancies the mothers had thrombophilia, 52 women were admitted with acute VTE and 184 had previous VTE. Other clinical risk factors included previous bad obstetric outcome, recurrent miscarriages, cardiac disorders or previous thromboembolic stroke. An individual risk assessment of each pregnant woman was performed. Very high risk females were treated with tinzaparin 90 – 100 IU/kg bid, high risk females were treated with tinzaparin 100 – 125 IU/kg daily and women with moderate risk were treated with 50 – 75 IU/kg daily. 302 of 305 pregnancies (99 %) in 263 females resulted in 310 healthy babies. 306 of 310 babies had appropriate birth weight for gestational week and all babies had normal Apgar score. Two females had miscarriages (week 10 and 20) and 1 female had an elective abortion. No females had pulmonary embolism. Deep venous thrombosis occurred in 4 of 305 pregnancies = 1,3 % (week 6, 11, 27 and one day postpartum). Wound hematoma was observed after cesarean section in two women and postpartum bleeding episodes (700 – 1500 ml) were observed in 7 women (4 had severe vaginal or cervical tearings, 2 had retained placenta and 1 had placental abruption). We found no incidence of thrombocytopenia or symptomatic osteoporosis. We find that individually dosed tinzaparin is safe and seems effective in the prevention of thromboembolic complications during pregnancy. Individual risk stratification is recommended.

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