Cargando…

Risk Factors for Pulmonary Embolism in Patients with Paralysis and Deep Venous Thrombosis

Background. Venous thromboembolism is a frequent complication and an important cause of death in patients with paralysis. We aimed to investigate predictors of pulmonary embolism (PE) and the impact of PE on the survival of patients with paralysis in comparison to those with deep venous thrombosis o...

Descripción completa

Detalles Bibliográficos
Autores principales: Keller, Karsten, Wöllner, Jens, Schmitt, Volker H., Ostad, Mir A., Sagoschen, Ingo, Münzel, Thomas, Espinola-Klein, Christine, Hobohm, Lukas
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8618323/
https://www.ncbi.nlm.nih.gov/pubmed/34830695
http://dx.doi.org/10.3390/jcm10225412
_version_ 1784604719867494400
author Keller, Karsten
Wöllner, Jens
Schmitt, Volker H.
Ostad, Mir A.
Sagoschen, Ingo
Münzel, Thomas
Espinola-Klein, Christine
Hobohm, Lukas
author_facet Keller, Karsten
Wöllner, Jens
Schmitt, Volker H.
Ostad, Mir A.
Sagoschen, Ingo
Münzel, Thomas
Espinola-Klein, Christine
Hobohm, Lukas
author_sort Keller, Karsten
collection PubMed
description Background. Venous thromboembolism is a frequent complication and an important cause of death in patients with paralysis. We aimed to investigate predictors of pulmonary embolism (PE) and the impact of PE on the survival of patients with paralysis in comparison to those with deep venous thrombosis or thrombophlebitis (DVT). Methods: Patients were selected by screening the German nationwide inpatient sample (2005–2017) for paralysis, and were stratified for venous thromboembolism (VTE) and the VTE-sub-entity PE (ICD-code I26). Impact of PE on mortality and predictors for PE were analyzed. Results: Overall, 7,873,769 hospitalizations of patients with paralysis were recorded in Germany 2005–2017, of whom 1.6% had VTE and 7.0% died. While annual hospitalizations increased (2005: 520,357 to 2017: 663,998) (β 12,421 (95% CI 10,807 to 14,034), p < 0.001), in-hospital mortality decreased from 7.5% to 6.7% (β −0.08% (95% CI −0.10% to −0.06%), p < 0.001). When focusing on 82,558 patients with paralysis hospitalized due to VTE (51.8% females; 58.3% aged ≥ 70 years) in 2005–2017, in-hospital mortality was significantly higher in patients with paralysis and PE than in those with DVT only (23.8% vs. 6.3%, p < 0.001). Cancer (OR 2.18 (95% CI 2.09–2.27), p < 0.001), heart failure (OR 1.83 (95% CI 1.76–1.91), p < 0.001), COPD (OR 1.63 (95% CI 1.53–1.72), p < 0.001) and obesity (OR 1.42 (95% CI 1.35–1.50), p < 0.001) were associated with PE. PE (OR 4.28 (95% CI 4.07–4.50), p < 0.001) was a strong predictor of in-hospital mortality. Conclusions: In Germany, annual hospitalizations of patients with paralysis increased in 2005–2017, in whom VTE and especially PE substantially affected in-hospital mortality. Cancer, heart failure, COPD, obesity and acute paraplegia were risk factors of PE.
format Online
Article
Text
id pubmed-8618323
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-86183232021-11-27 Risk Factors for Pulmonary Embolism in Patients with Paralysis and Deep Venous Thrombosis Keller, Karsten Wöllner, Jens Schmitt, Volker H. Ostad, Mir A. Sagoschen, Ingo Münzel, Thomas Espinola-Klein, Christine Hobohm, Lukas J Clin Med Article Background. Venous thromboembolism is a frequent complication and an important cause of death in patients with paralysis. We aimed to investigate predictors of pulmonary embolism (PE) and the impact of PE on the survival of patients with paralysis in comparison to those with deep venous thrombosis or thrombophlebitis (DVT). Methods: Patients were selected by screening the German nationwide inpatient sample (2005–2017) for paralysis, and were stratified for venous thromboembolism (VTE) and the VTE-sub-entity PE (ICD-code I26). Impact of PE on mortality and predictors for PE were analyzed. Results: Overall, 7,873,769 hospitalizations of patients with paralysis were recorded in Germany 2005–2017, of whom 1.6% had VTE and 7.0% died. While annual hospitalizations increased (2005: 520,357 to 2017: 663,998) (β 12,421 (95% CI 10,807 to 14,034), p < 0.001), in-hospital mortality decreased from 7.5% to 6.7% (β −0.08% (95% CI −0.10% to −0.06%), p < 0.001). When focusing on 82,558 patients with paralysis hospitalized due to VTE (51.8% females; 58.3% aged ≥ 70 years) in 2005–2017, in-hospital mortality was significantly higher in patients with paralysis and PE than in those with DVT only (23.8% vs. 6.3%, p < 0.001). Cancer (OR 2.18 (95% CI 2.09–2.27), p < 0.001), heart failure (OR 1.83 (95% CI 1.76–1.91), p < 0.001), COPD (OR 1.63 (95% CI 1.53–1.72), p < 0.001) and obesity (OR 1.42 (95% CI 1.35–1.50), p < 0.001) were associated with PE. PE (OR 4.28 (95% CI 4.07–4.50), p < 0.001) was a strong predictor of in-hospital mortality. Conclusions: In Germany, annual hospitalizations of patients with paralysis increased in 2005–2017, in whom VTE and especially PE substantially affected in-hospital mortality. Cancer, heart failure, COPD, obesity and acute paraplegia were risk factors of PE. MDPI 2021-11-19 /pmc/articles/PMC8618323/ /pubmed/34830695 http://dx.doi.org/10.3390/jcm10225412 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Keller, Karsten
Wöllner, Jens
Schmitt, Volker H.
Ostad, Mir A.
Sagoschen, Ingo
Münzel, Thomas
Espinola-Klein, Christine
Hobohm, Lukas
Risk Factors for Pulmonary Embolism in Patients with Paralysis and Deep Venous Thrombosis
title Risk Factors for Pulmonary Embolism in Patients with Paralysis and Deep Venous Thrombosis
title_full Risk Factors for Pulmonary Embolism in Patients with Paralysis and Deep Venous Thrombosis
title_fullStr Risk Factors for Pulmonary Embolism in Patients with Paralysis and Deep Venous Thrombosis
title_full_unstemmed Risk Factors for Pulmonary Embolism in Patients with Paralysis and Deep Venous Thrombosis
title_short Risk Factors for Pulmonary Embolism in Patients with Paralysis and Deep Venous Thrombosis
title_sort risk factors for pulmonary embolism in patients with paralysis and deep venous thrombosis
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8618323/
https://www.ncbi.nlm.nih.gov/pubmed/34830695
http://dx.doi.org/10.3390/jcm10225412
work_keys_str_mv AT kellerkarsten riskfactorsforpulmonaryembolisminpatientswithparalysisanddeepvenousthrombosis
AT wollnerjens riskfactorsforpulmonaryembolisminpatientswithparalysisanddeepvenousthrombosis
AT schmittvolkerh riskfactorsforpulmonaryembolisminpatientswithparalysisanddeepvenousthrombosis
AT ostadmira riskfactorsforpulmonaryembolisminpatientswithparalysisanddeepvenousthrombosis
AT sagoscheningo riskfactorsforpulmonaryembolisminpatientswithparalysisanddeepvenousthrombosis
AT munzelthomas riskfactorsforpulmonaryembolisminpatientswithparalysisanddeepvenousthrombosis
AT espinolakleinchristine riskfactorsforpulmonaryembolisminpatientswithparalysisanddeepvenousthrombosis
AT hobohmlukas riskfactorsforpulmonaryembolisminpatientswithparalysisanddeepvenousthrombosis