scholarly journals Prevalence, Risk, and Outcome of Deep Vein Thrombosis in Acute Respiratory Distress Syndrome

2021 ◽  
Author(s):  
Na Cui ◽  
Chunguo Jiang ◽  
Hairong Chen ◽  
Liming Zhang ◽  
Xiaokai Feng
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Deep Vein Thrombosis ◽  
Serum Creatinine ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Serum Creatinine Level ◽  
Creatinine Level ◽  
Distress Syndrome ◽  
Vein Thrombosis ◽  
Deep Vein

Abstract Background: Few data exist on deep vein thrombosis (DVT) in patients with acute respiratory distress syndrome (ARDS), a group of heterogeneous diseases characterized by acute hypoxemia.Study Design and Methods: We retrospectively enrolled 225 adults with ARDS admitted to the Beijing Chao-Yang Hospital and the First Affiliated Hospital of Shandong First Medical University between 1 January 2015 and 30 June 2020. We analyzed clinical, laboratory, and echocardiography data for groups with and without DVT and for direct and indirect ARDS subgroups.Results: Ninety (40.0%) patients developed DVT. Compared with the non-DVT group, patients with DVT were older, had lower serum creatinine levels, lower partial pressure of arterial oxygen/fraction of inspired oxygen, higher serum procalcitonin levels, higher Padua prediction scores, and higher proportions of sedation and invasive mechanical ventilation (IMV). Multivariate analysis showed an association between age, serum creatinine level, IMV, and DVT in the ARDS cohort. The sensitivity and specificity of corresponding receiver operating characteristic curves were not inferior to those of the Padua prediction score and the Caprini score for screening for DVT in the three ARDS cohorts. Patients with DVT had a significantly lower survival rate than those without DVT in the overall ARDS cohort and in the groups with direct and indirect ARDS.Conclusions: The prevalence of DVT is high in patients with ARDS. The risk factors for DVT are age, serum creatinine level, and IMV, which predict DVT and are not inferior to the Padua prediction score and the Caprini score. DVT is associated with decreased survival in patients with ARDS.

scholarly journals Prevalence, Risk, and Outcome of Deep Vein Thrombosis in Acute Respiratory Distress Syndrome

2021 ◽  
Author(s):  
Na Cui ◽  
Chunguo Jiang ◽  
Hairong Chen ◽  
Yuan Gao ◽  
Lifeng Yu ◽  
...  
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Deep Vein Thrombosis ◽  
Serum Creatinine ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Serum Creatinine Level ◽  
Creatinine Level ◽  
Distress Syndrome ◽  
Vein Thrombosis ◽  
Deep Vein

Abstract Background: Few data exist on deep vein thrombosis (DVT) in patients with acute respiratory distress syndrome (ARDS), a group of heterogeneous diseases characterized by acute hypoxemia.Study Design and Methods: We retrospectively enrolled 225 adults with ARDS admitted to the Beijing Chao-Yang Hospital and the First Affiliated Hospital of Shandong First Medical University between 1 January 2015 and 30 June 2020. We analyzed clinical, laboratory, and echocardiography data for groups with and without DVT and for direct and indirect ARDS subgroups.Results: Ninety (40.0%) patients developed DVT. Compared with the non-DVT group, patients with DVT were older, had lower serum creatinine levels, lower partial pressure of arterial oxygen/fraction of inspired oxygen, higher serum procalcitonin levels, higher Padua prediction scores, and higher proportions of sedation and invasive mechanical ventilation (IMV). Multivariate analysis showed an association between age, serum creatinine level, IMV, and DVT in the ARDS cohort. The sensitivity and specificity of corresponding receiver operating characteristic curves were not inferior to those of the Padua prediction score and the Caprini score for screening for DVT in the three ARDS cohorts. Patients with DVT had a significantly lower survival rate than those without DVT in the overall ARDS cohort and in the groups with direct and indirect ARDS.Conclusions: The prevalence of DVT is high in patients with ARDS. The risk factors for DVT are age, serum creatinine level, and IMV, which predict DVT and are superior to the Padua prediction score and the Caprini score. DVT is associated with decreased survival in patients with ARDS.

scholarly journals Prevalence, risk, and outcome of deep vein thrombosis in acute respiratory distress syndrome

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Na Cui ◽  
Chunguo Jiang ◽  
Hairong Chen ◽  
Liming Zhang ◽  
Xiaokai Feng
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Deep Vein Thrombosis ◽  
Serum Creatinine ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Serum Creatinine Level ◽  
Creatinine Level ◽  
Distress Syndrome ◽  
Vein Thrombosis ◽  
Deep Vein

Abstract Background Few data exist on deep vein thrombosis (DVT) in patients with acute respiratory distress syndrome (ARDS), a group of heterogeneous diseases characterized by acute hypoxemia. Study design and methods We retrospectively enrolled 225 adults with ARDS admitted to the Beijing Chao-Yang Hospital and the First Affiliated Hospital of Shandong First Medical University between 1 January 2015 and 30 June 2020. We analyzed clinical, laboratory, and echocardiography data for groups with and without DVT and for direct (pulmonary) and indirect (extrapulmonary) ARDS subgroups. Results Ninety (40.0%) patients developed DVT. Compared with the non-DVT group, patients with DVT were older, had lower serum creatinine levels, lower partial pressure of arterial oxygen/fraction of inspired oxygen, higher serum procalcitonin levels, higher Padua prediction scores, and higher proportions of sedation and invasive mechanical ventilation (IMV). Multivariate analysis showed an association between age, serum creatinine level, IMV, and DVT in the ARDS cohort. The sensitivity and specificity of corresponding receiver operating characteristic curves were not inferior to those of the Padua prediction score and the Caprini score for screening for DVT in the three ARDS cohorts. Patients with DVT had a significantly lower survival rate than those without DVT in the overall ARDS cohort and in the groups with direct and indirect ARDS. Conclusions The prevalence of DVT is high in patients with ARDS. The risk factors for DVT are age, serum creatinine level, and IMV. DVT is associated with decreased survival in patients with ARDS.

scholarly journals Deep vein thrombosis in acute respiratory distress syndrome caused by bacterial pneumonia

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Na Cui ◽  
Song Mi ◽  
Chunguo Jiang ◽  
Wanlu Sun ◽  
Wenping Mao ◽  
...  
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Deep Vein Thrombosis ◽  
Serum Creatinine ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Bacterial Pneumonia ◽  
Distress Syndrome ◽  
Invasive Mechanical Ventilation ◽  
Vein Thrombosis ◽  
Deep Vein

Abstract Background Acute respiratory distress syndrome (ARDS) is a clinical syndrome characterized by acute hypoxaemia, and few studies have reported the incidence of deep vein thrombosis (DVT) in direct ARDS caused by bacterial pneumonia. We performed a study to evaluate the prevalence, risk factors, prognosis and potential thromboprophylaxis strategies of DVT in these patients. Methods Ninety patients were included. Demographic, and clinical data, laboratory data and outcome variables were obtained, and comparisons were made between the DVT and non-DVT groups. Results Of the 90 patients, 40 (44.4%) developed lower extremity DVT. Compared with non-DVT patients, DVT patients had higher systemic inflammatory response syndrome (SIRS) scores, lower serum creatinine levels, higher D-dimer levels, and higher rates of sedative therapy and invasive mechanical ventilation (IMV). Multivariate analysis showed an association between the SIRS score (OR 3.803, P = 0.027), level of serum creatinine (OR 0.988, P = 0.001), IMV (OR 5.822, P = 0.002) and DVT. The combination of SIRS score, serum creatinine level and IMV has a sensitivity of 80.0% and a specificity of 74.0% for screening for DVT. The survival rate within 28 days after ARDS in the DVT group was significantly lower than that in the non-DVT group (P = 0.003). There was no difference in the prevalence of DVT between the 41 patients who received thromboprophylaxis and the 49 patients who did not receive thromboprophylaxis (41.5% vs 46.9%; P = 0.603). Conclusions The prevalence of DVT is high in hospitalized patients with direct ARDS caused by bacterial pneumonia and may be associated with adverse outcomes. The current thromboprophylaxis strategies may need to be further optimized.

scholarly journals Comparison of deep vein thrombosis risks in acute respiratory distress syndrome Caused by COVID-19 and Bacterial Pneumonia: A Retrospective Cohort Study

2022 ◽  
Author(s):  
Na Cui ◽  
Chunguo Jiang ◽  
Chenlu Yang ◽  
Liming Zhang ◽  
Xiaokai Feng
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Cohort Study ◽  
Deep Vein Thrombosis ◽  
Respiratory Distress Syndrome ◽  
Retrospective Cohort ◽  
Bacterial Pneumonia ◽  
Distress Syndrome ◽  
Vein Thrombosis ◽  
Deep Vein ◽  
D Dimer

Abstract Background: High incidence of deep vein thrombosis (DVT) has been observed in patients with acute respiratory distress syndrome (ARDS) caused by COVID-19 and those by bacterial pneumonia. However, it is also important to differentiate between these two groups of patients. Study Design and Methods: We performed a retrospective cohort study to investigate the difference of DVT between the two independent cohorts of ARDS and eventually enrolled 240 patients, 105 of whom with ARDS caused by COVID-19 and 135 by bacterial pneumonia. We analyzed demographics and clinical characteristics for patients with and without DVT in these two cohorts and explored the main differences and similarities between them.Results: The 28-days incidence of DVT in COVID-19 cohort was higher than that in bacterial pneumonia cohort (57.1% vs 41.5%, P=0.016). Taking death as competitive risk, Fine-Gray test showed no significant difference in 28-day cumulative incidence of DVT between these two groups (P=0.220). Fine-Gray competing risk analysis showed an association between CK (creatine kinase isoenzyme)-MB levels, PaO2 (partial pressure of arterial oxygen)/FiO2 (fraction of inspired oxygen) ratios, D-dimer levels and DVT in COVID-19 cohort and an association between serum creatinine levels, IMV, and DVT in bacterial pneumonia cohort. The sensitivity and specificity of corresponding receiver operating characteristic curve originating from the combination of CK-MB levels, PaO2/FiO2 ratios and D-dimer levels ≥ 0.5 µg/mL was not inferior to those of the Padua prediction score and the Wells score for screening for DVT in COVID-19 cohort.Conclusions: Compared with patients with ARDS caused by bacterial pneumonia, the incidence of DVT is higher by logistic model in patients with ARDS caused by COVID-19, and the risk factors for DVT are completely different. Our novel prediction model can aid early identifying patients with high risk for DVT.

scholarly journals Predictors of Mortality Among COVID-19 Patients With or Without Comorbid Diabetes Mellitus

2021 ◽  
Author(s):  
Seyedreza Mirsoleymani ◽  
Erfan Taherifard ◽  
Ehsan Taherifard ◽  
Mohammad Hossein Taghrir ◽  
Milad Ahmadi Marzaleh ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Acute Respiratory Distress Syndrome ◽  
Serum Creatinine ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Neutrophil Count ◽  
Distress Syndrome ◽  
Diabetic Patients ◽  
C Reactive Protein ◽  
Reactive Protein

Late in 2019, the first case of COVID-19 was detected in China, and the disease caused a pandemic state worldwide. Up to now, many studies have investigated the impact of comorbid diseases, especially diabetes mellitus, on COVID-19 outcomes. In this study, we aimed to assess the para-clinic characteristics of COVID-19 patients with or without diabetes mellitus to identify factors indicative of poor prognoses. In this prospective study, 153 in-patients with COVID-19 were followed up from 1 March to 19 April. Paraclinical information of these patients was gathered from their medical records. Afterward, the association between these factors among both diabetic and non-diabetic patients was assessed in the correlation analyses. Discharge and expiration of 77.1% and 22.9% of the study participants resulted in a 1063 person-day follow-up for patients who were discharged healthily and 384 person-day follow-ups for expired patients. 41.8% of the participants had diabetes mellitus. Lymphocytopenia and Neutrolhilia prevalences increased during hospitalization; comparing with their initial prevalences. Thirty-seven patients got acute respiratory distress syndrome; of those, 35 died. The mean of the initial C reactive protein level was 42.49, and serum creatinine of 1.39. The study showed that higher initial neutrophil count, increasing neutrophil count more than 15000 and decreasing lymphocyte count below 1000 during hospitalization; development of acute respiratory distress syndrome and being intubated; initial C reactive protein and serum creatinine level were associated with higher mortality rates in COVID-19 victims.

COVID-19 – eine vaskuläre Systemerkrankung

2020 ◽  
Vol 49 (10) ◽  
pp. 418-421
Author(s):  
Christopher Werlein ◽  
Peter Braubach ◽  
Vincent Schmidt ◽  
Nicolas J. Dickgreber ◽  
Bruno Märkl ◽  
...  
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome

ZUSAMMENFASSUNGDie aktuelle COVID-19-Pandemie verzeichnet mittlerweile über 18 Millionen Erkrankte und 680 000 Todesfälle weltweit. Für die hohe Variabilität sowohl der Schweregrade des klinischen Verlaufs als auch der Organmanifestationen fanden sich zunächst keine pathophysiologisch zufriedenstellenden Erklärungen. Bei schweren Krankheitsverläufen steht in der Regel eine pulmonale Symptomatik im Vordergrund, meist unter dem Bild eines „acute respiratory distress syndrome“ (ARDS). Darüber hinaus zeigen sich jedoch in unterschiedlicher Häufigkeit Organmanifestationen in Haut, Herz, Nieren, Gehirn und anderen viszeralen Organen, die v. a. durch eine Perfusionsstörung durch direkte oder indirekte Gefäßwandschädigung zu erklären sind. Daher wird COVID-19 als vaskuläre Multisystemerkrankung aufgefasst. Vor dem Hintergrund der multiplen Organmanifestationen sind klinisch-pathologische Obduktionen eine wichtige Grundlage der Entschlüsselung der Pathomechanismen von COVID-19 und auch ein Instrument zur Generierung und Hinterfragung innovativer Therapieansätze.

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