A retrospective study of risk factors for calf venous thrombosis in patients with cerebral hemorrhage

2020 ◽  
Author(s):  
Xiaogang Gao ◽  
Yi Li ◽  
Dongzhe Hou

Abstract Purpose:To investigate the risk factors for calf venous thrombosis in patients with cerebral hemorrhage, so as to provide a reference for customized clinical decision.Methods:396 intracerebral hemorrhage (ICH) patients were enrolled in this retrospective study from January 2017 to December 2019. Risk factors and predictors of occurrence for Muscle calf venous thrombosis (MCVT) were summarized and analyzed by Chi-square test and logistic regression analysis.Results: 128 ICH patients with MCVT and 268 without ones were included. Demographic features comparison showed that ICH with MCVT patients showed older average age than those without ones (p=0.039). Co-morbid diseases analysis showed that patients with MCVT tend to complicate with Diabetes Mellitus (DM) (p=0.040). The comparison of laboratory examinations showed serum level of glucose (p=0.011), Fibrinogen (p=0.046) and D-Dimer (p=0.007) was significantly different. For clinical manifestations, the coma degree (GCS score) and muscle strength level were related to occurring of MCVT. Multivariate logistic regression identified higher age (OR=1.036, 95%CI =1.009-1.064, P= 0.008), higher D-Dimer level (OR=2.379, 95%CI =1.338-4.231, P= 0.003), low GCS (OR=0.932, 95%CI =0.868-0.998, P= 0.044) and lower affected side muscle strength (0-3 grade) (OR=1.624, 95%CI =1.009-2.614, P= 0.046) will predict higher incidence of MCVT in ICH patients.Conclusion: According to our study, higher age, higher D-Dimer level, lower GCS score and lower affected side muscle strength were associated with higher incidence of MCVT in ICH patients. Clinical doctors should pay more attention to prevent MCVT in ICH patients which coincide with those risk factors.

2020 ◽  
pp. 112972982098320
Author(s):  
Karolina Chojnacka ◽  
Zbigniew Krasiński ◽  
Katarzyna Wróblewska-Seniuk ◽  
Jan Mazela

Introduction: Newborns treated in a neonatal intensive care unit (NICU) are susceptible to several complications one of them being vein thrombosis. Aim: The study aims to evaluate risk factors of catheter-related venous thrombosis, clinical manifestations, treatment, and the outcomes of thrombotic events (TE) during the neonatal period. Methods: This work is a case-control retrospective study performed on patients in the tertiary NICU between January 2013 and June 2016. The analysis includes data from infants with CVC diagnosed with thrombosis and infants with CVC, not being diagnosed with thrombosis (control group). Statistica 10 software was used for statistical analysis. Results: Vein thrombosis was diagnosed in 19 NICU infants including 16 cases of catheter-related vein thrombosis (84% of complicated cases). Other statistically significant risk factors were asphyxia, infection, and the duration of CVC use. The incidence of thrombosis in our population increased during the study which may result from a statistically significant increase in the number of inserted CVC (294 vs 435), and more frequent diagnosis of incidental thrombosis (1 vs 9). Conclusion: Vein catheterization, asphyxia, infection, and prolonged CVC use are critical risk factors for thrombosis in the neonatal period. Given the hereinbefore mentioned increased number of central line catheterizations in the NICU, it would be useful to conduct a prospective study with a scheduled routine ultrasound protocol applied not only as a tool to diagnose thrombosis but also to prevent it by determining a proper catheter for a particular vein.


2021 ◽  
Author(s):  
Huizi Zhu ◽  
Liang Xu ◽  
Xiang Liu ◽  
Bing Liu ◽  
Xiaowei Yang ◽  
...  

Abstract BackgroundPrimary membranous nephropathy (PMN) is associated with the highest risk for developing venous thrombosis compared with other nephrotic diseases. The aim of the study was to assess the predictive value of the pathognomonic anti-PLA2R antibody with regard to incidence of venous thrombosis in PMN.Methods269 PMN patients with venous thrombosis examination were collected and analyzed. Anti-PLA2R antibodies were detected by commercial enzyme-linked immunosorbent assay. Multivariate Logistic regression was used to detect the independent risk factors for venous thrombosis.Results28 patients (10.4%) had venous thrombosis. Patients with venous thrombosis had higher levels of CHOL, LDL, and D-dimer than those without venous thrombosis (P<0.05). Patients with venous thrombosis had significantly lower levels of ALB (23.26 ± 5.24 vs. 26.00 ± 6.69 g/L, P=0.037). No significant differences were found in urine proteinuria, SCR, eGFR, platelets and fibrinogen between patients with and without thrombosis. Anti-PLA2R antibody levels in patients with venous thrombosis were significantly higher than in patients without it (P=0.010). In the univariate logistic regression, Ln PLA2R (OR: 1.316; P=0.032), ALB (OR: 0.932; P=0.039), CHOL (OR: 1.189, P=0.015) , and LDL (OR: 1.288,P=0.009) were associated with venous thrombosis. PLA2R-Ab (OR=1.316; 95%CI: 1.024~1.691), and LDL (OR=1.229; 95%CI: 1.012~1.493) were the independent risk factors for venous thrombosis (P<0.05) in multivariate analysis.ConclusionAnti-PLA2R antibody was the independent risk factor for venous thrombosis in PMN. Larger prospective studies were warranted to verify the results in future.


2020 ◽  
Author(s):  
Yi Guo ◽  
Yun You ◽  
Ke Hu ◽  
Fei Cai ◽  
Yiqing Li ◽  
...  

Abstract BackgroundDeep venous thrombosis (DVT) is a severe complication of the coronavirus disease 2019 (COVID-19). It may interfere with COVID-19 treatment and delay the recovery, but there is less data about the anticoagulant therapy and sex difference of VTE in patients with COVID-19. The purpose of this study is to study the prevalence, risk factors, anticoagulant therapy and sex difference of deep venous thrombosis (DVT) in patients with COVID-19.MethodsThe enrolled 121 patients were confirmed positive for COVID-19. All suspected patients with a high Caprini index (≥4) or PADUA index (≥4) received color Doppler Ultrasound (US) to screen DVT in both lower extremities. Clinical characteristics of DVT-COVID-19 patients were analyzed. Multivariate logistic regression was performed to identify risk factors related to DVT in COVID-19 patients. The distribution of DVT locations, anticoagulation therapy with sex difference, and the outcomes were also analyzed.ResultsDVT was found in 48% asymptomatic COVID-19 patients with increased PAUDA index or Caprini index by US scanning. Multivariate logistic regression determined that age, CRP and baseline D-dimer were risk factors among COVDI-19 patients. Although the most common DVT location was infrapopliteal (Class I and Class II), higher mortality in DVT-COVID-19 patients was confirmed. DVT-COVID-19 patients presented significant increases in the CRP, neutrophil count and D-dimer throughout the whole inpatient period compared to non-DVT-COVID-19 patients. Although anticoagulation therapy accelerated the recovery of lymphocytopenia condition in DVT patients, men DVT-COVID-19 patients showed higher CRP and neutrophil count vs. lymphocyte count (N/L) ratio but lower lymphocyte count compared to women DVT-COVID-19 patients. ConclusionsDVT is common in COVID-19 patients with high risk factors, especially for older age, higher CRP and baseline D-dimer populations. It is important to consider sex differences in the anticoagulant therapy among DVT-COVID-19 patients.


2020 ◽  
Vol 26 ◽  
pp. 107602962098266
Author(s):  
Chuanqi Cai ◽  
Yi Guo ◽  
Yun You ◽  
Ke Hu ◽  
Fei Cai ◽  
...  

Deep venous thrombosis (DVT) is a severe complication of coronavirus disease 2019 (COVID-19). The purpose of this study was to study the prevalence, risk factors, anticoagulant therapy and sex differences of DVT in patients with COVID-19. The enrolled 121 hospitalized non-ventilator patients were confirmed positive for COVID-19. All suspected patients received color Doppler ultrasound (US) to screen for DVT in both lower extremities. Multivariate logistic regression was performed to identify risk factors related to DVT in COVID-19 patients. DVT was found in 48% of the asymptomatic COVID-19 patients with an increased PADUA or Caprini index using US scanning. The multivariate logistic regression determined that age (OR, 1.05; p = .0306), C-reactive protein (CRP) (OR, 1.02; p = .0040), and baseline D-dimer (OR, 1.42; p = .0010) were risk factors among COVID-19 patients. Although the most common DVT location was infrapopliteal (classes I and II), higher mortality in DVT-COVID-19 patients was confirmed. DVT-COVID-19 patients presented significant increases in CRP, neutrophil count, and D-dimer throughout the whole inpatient period compared to non-DVT-COVID-19 patients. Although anticoagulation therapy accelerated the recovery of lymphocytopenia in DVT patients, men DVT-COVID-19 patients with anticoagulant therapy showed significant higher CRP and neutrophil count vs. lymphocyte count (N/L) ratio, but showed lower lymphocyte counts compared to women DVT-COVID-19 patients. DVT is common in COVID-19 patients with high-risk factors, especially for older age and higher CRP and baseline D-dimer populations. It is important to consider sex differences in anticoagulant therapy among DVT-COVID-19 patients.


2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Rui He ◽  
Guoyou Wang ◽  
Ting Li ◽  
Huarui Shen ◽  
LijuanZhang

Abstract Background Postoperative ischemic stroke is a devastating complication following total hip arthroplasty (THA). The purpose of the current study was to investigate the incidence of postoperative acute ischemic stroke (AIS) in patients ≥70 years old with THA for hip fracture after 90 days and independent risk factors associated with 90-day AIS. Methods A multicenter retrospective study was conducted, patients ≥70 years old with THA for hip fracture under general anesthesia were included from February 2017 to March 2020. Patients with AIS within 90 days after THA were identified as AIS group; patients with no AIS were identified as no AIS group. The baseline characteristics and risk factors were collected, multivariable logistic regression was used to identify independent risk factors of 90-dayAIS. Results: 2517 patients (mean age 76.18 ± 6.01) were eligible for inclusion in the study. 2.50% (63/2517) of patients had 90-day AIS. Compared with no AIS, older age, diabetes, hyperlipidemia, atrial fibrillation (AF) and higher D-dimer value were more likely in patients with AIS (P < 0.05), and anticoagulant use was fewer in patients with AIS. ROC curve analysis showed that the optimal cut point of D-dimer for AIS was D-dimer≥4.12 μg/ml. Multivariate logistic regression analysis showed that D-dimer≥4.12 μg/ml [adjusted odds ratio (aOR), 4.44; confidence interval (CI), 2.50–7.72; P < 0.001], older age (aOR, 1.08; 95%CI, 1.03–1.12; P < 0.001), hyperlipidemia (aOR, 2.28; 95%CI, 1.25–4.16; P = 0.007), atrial fibrillation (aOR, 5.84; 95% CI, 1.08–15.68; P = 0.001), and diabetes (aOR, 2.60; 95% CI, 1.56–4.39; P < 0.001) were associated with increased risk of 90-day AIS after THA. Conclusions In conclusion, we found that the incidence of 90-day AIS in patients≥70 years old with THA for hip fracture was 2.5%. Older age, diabetes, hyperlipidemia, AF and higher D-dimer value were independent risk factors for 90-day AIS in patients≥70 years old with THA for hip fracture.


2020 ◽  
Author(s):  
Tingya Wang ◽  
Haijun Zhang

Abstract Background. The study aimed to explore the influence of hepatitis B virus (HBV) infection on the risk of synchronous gastric cancer liver metastasis (synGCLM).Methods. This was a retrospective study which enrolled 868 patients with newly diagnosed gastric cancer (GC). The study compared the prevalence of synGCLM between hepatitis B surface antigen (HBsAg)-positive (HBsAg+) and -negative (HBsAg-) patients. Logistic regression analysis was utilized to analyze the risk factors for synGCLM. Among patients with and without synGCLM, aspartate aminotransferase to platelet ratio index (APRI), liver fibrosis-4 index (FIB-4) and hepatitis B e antigen (HBeAg) status were further analyzed. Results. The prevalence of synGCLM in the HBsAg+ patients was higher than that in the HBsAg- patients, which was statistically significant (P = 0.025). Multivariate logistic regression analysis demonstrated that HBsAg, the elevated level of carcinoembryonic antigen (CEA), alpha-fetoprotein (AFP), γ-glutamyltransferase (GGT) and alkaline phosphatase (ALP) were risk factors for synGCLM. Among the HBsAg+ patients, both ARPI and FIB-4 were significantly higher in the patients with synGCLM (synGCLM+) than those without synGCLM (synGCLM-) (ARPI: P = 0.045; FIB-4: P = 0.047); HBeAg positivity was detected in 20.0% of synGCLM+ patients compared to 6.0% of synGCLM- patients, but the difference was of no significance (P = 0.190). Conclusions. HBV infection significantly increases the risk of synGCLM, and elevated ARPI and FIB-4 may be pro-metastatic especially among the HBsAg+ GC patients.


2022 ◽  
Vol 8 ◽  
Author(s):  
Han Zhang ◽  
Yingying Wu ◽  
Yuqing He ◽  
Xingyuan Liu ◽  
Mingqian Liu ◽  
...  

Objective: To study the differences in clinical characteristics, risk factors, and complications across age-groups among the inpatients with the coronavirus disease 2019 (COVID-19).Methods: In this population-based retrospective study, we included all the positive hospitalized patients with COVID-19 at Wuhan City from December 29, 2019 to April 15, 2020, during the first pandemic wave. Multivariate logistic regression analyses were used to explore the risk factors for death from COVID-19. Canonical correlation analysis (CCA) was performed to study the associations between comorbidities and complications.Results: There are 36,358 patients in the final cohort, of whom 2,492 (6.85%) died. Greater age (odds ration [OR] = 1.061 [95% CI 1.057–1.065], p &lt; 0.001), male gender (OR = 1.726 [95% CI 1.582–1.885], p &lt; 0.001), alcohol consumption (OR = 1.558 [95% CI 1.355–1.786], p &lt; 0.001), smoking (OR = 1.326 [95% CI 1.055–1.652], p = 0.014), hypertension (OR = 1.175 [95% CI 1.067–1.293], p = 0.001), diabetes (OR = 1.258 [95% CI 1.118–1.413], p &lt; 0.001), cancer (OR = 1.86 [95% CI 1.507–2.279], p &lt; 0.001), chronic kidney disease (CKD) (OR = 1.745 [95% CI 1.427–2.12], p &lt; 0.001), and intracerebral hemorrhage (ICH) (OR = 1.96 [95% CI 1.323–2.846], p = 0.001) were independent risk factors for death from COVID-19. Patients aged 40–80 years make up the majority of the whole patients, and them had similar risk factors with the whole patients. For patients aged &lt;40 years, only cancer (OR = 17.112 [95% CI 6.264–39.73], p &lt; 0.001) and ICH (OR = 31.538 [95% CI 5.213–158.787], p &lt; 0.001) were significantly associated with higher odds of death. For patients aged &gt;80 years, only age (OR = 1.033 [95% CI 1.008–1.059], p = 0.01) and male gender (OR = 1.585 [95% CI 1.301–1.933], p &lt; 0.001) were associated with higher odds of death. The incidence of most complications increases with age, but arrhythmias, gastrointestinal bleeding, and sepsis were more common in younger deceased patients with COVID-19, with only arrhythmia reaching statistical difference (p = 0.039). We found a relatively poor correlation between preexisting risk factors and complications.Conclusions: Coronavirus disease 2019 are disproportionally affected by age for its clinical manifestations, risk factors, complications, and outcomes. Prior complications have little effect on the incidence of extrapulmonary complications.


2021 ◽  
Vol 8 ◽  
Author(s):  
Xiya Lu ◽  
Zhijing Wang ◽  
Liu Yang ◽  
Changqing Yang ◽  
Meiyi Song

Background and Objectives: Liver cirrhosis is known to be associated with atrial arrhythmia. However, the risk factors for atrial arrhythmia in patients with liver cirrhosis remain unclear. This retrospective study aimed to investigate the risk factors for atrial arrhythmia in patients with liver cirrhosis.Methods: In the present study, we collected data from 135 patients with liver cirrhosis who were admitted to the Department of Gastroenterology at Shanghai Tongji Hospital. We examined the clinical information recorded, with the aim of identifying the risk factors for atrial arrhythmia in patients with liver cirrhosis. Multiple logistic regression analysis was used to screen for significant factors differentiating liver cirrhosis patients with atrial arrhythmia from those without atrial arrhythmia.Results: The data showed that there were seven significantly different factors that distinguished the group with atrial arrhythmia from the group without atrial arrhythmia. The seven factors were age, white blood cell count (WBC), albumin (ALB), serum Na+, B-type natriuretic peptide (BNP), ascites, and Child-Pugh score. The results of multivariate logistic regression analysis suggested that age (β = 0.094, OR = 1.098, 95% CI 1.039–1.161, P = 0.001) and ascites (β =1.354, OR = 3.874, 95% CI 1.202–12.483, P = 0.023) were significantly associated with atrial arrhythmia.Conclusion: In the present study, age and ascites were confirmed to be risk factors associated with atrial arrhythmia in patients with liver cirrhosis.


2020 ◽  
Author(s):  
Samuel Z. Goldhaber

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


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