Influencing factors of short-term progression of lower extremity distal deep vein thrombosis
Objective To analyze the clinical data of patients with lower extremity distal deep vein thrombosis(DDVT),and to explore the influencing factors of short-term progression of DDVT.Methods The clinical data of 165 patients with DDVT in Henan Provincial People's Hospital from January 2020 to January 2022 were retrospectively analyzed.All patients underwent lower extremity vascular ultrasound after admission,and were decided to perform anticoagulation therapy or not and the anticoagulant dose according to the thrombus condition,clinical symptoms and bleeding risk assessment.Lower extremity vascular ultrasound or pulmonary arteriography were performed 2 weeks later,showing 110 patients with no change or disappearance of DDVT(non-progression group)and 55 patients with progression of DDVT to popliteal vein,femoral vein,iliac vein or asymptomatic pulmonary embolism(progression group).The gender ratio,age,body mass index,comorbidities(hypertension,diabetes,coronary heart disease),smoking habits,thrombus site,surgery history within one month,thrombus history,lower extremity edema,active tumor,central venous catheterization,bed rest＞3 d,anticoagulation therapy rate and bleeding complications were compared between two groups.The white blood cell count,platelet count,hemoglobin,C-reactive protein,albumin,lactate dehydrogenase,fasting plasma glucose,blood creatinine,prothrombin time,prothrombin activity,activated partial thromboplastin time,D-dimer,total cholesterol,and triacylglycerol were recorded on admission.Multivariate logistic regression analysis was done to assess the influencing factors of DDVT short-term progression.Results In 165 patients,anticoagulation therapy was fulfilled in 129 patients,with no bleeding complications.The proportions of active tumor,surgery history within one month,thrombosis history,and bed rest＞3 d were higher in progression group(20.0％,47.3％,14.5％,56.4％)than those in non-progression group(8.2％,30.0％,3.6％,39.1％)(P＜0.05),the rate of anticoagulation therapy was lower in progression group(61.8％)than that in non-progression group(86.4％)(P＜0.05),and there were no significant differences in the gender ratio,age,body mass index,rate of comorbidities(hypertension,diabetes,coronary heart disease),thrombus site,proportions of smoking habits,lower extremity edema and central venous catheterization,and admission laboratory indexes(white blood cell count,platelet count,hemoglobin,C-reactive protein,albumin,lactate dehydrogenase,fasting plasma glucose,blood creatinine,prothrombin time,prothrombin activity,activated partial thromboplastin time,D-dimer,total cholesterol,triacylglycerol)between two groups(P＞0.05).(2)History of thrombosis(OR=9.037,95％CI:2.235-36.538,P=0.002)and active tumor(OR=3.734,95％CI:1.274-10.940,P=0.016)were the risk factors of short-term progression of DDVT,and anticoagulation therapy(OR=0.150,95％CI:0.062-0.362,P＜0.001)was a protective factor.Conclusion DDVT patients with history of thrombosis and active tumors are prone to short-term DDVT progression,and anticoagulation therapy can reduce the risk of DDVT.
distal deep vein thrombosisrisk factorsprogression of thrombuspulmonary embolism
NETL
NSTL
万方数据
维普
