PDF(Pubmed)
Abstract：
Recent surgery is a well-known major transient risk factor for venous thromboembolism (VTE) due to the low risk of VTE recurrence after anticoagulation is discontinued. On the other hand, the risk of VTE recurrence among patients with COVID-19-associated VTE is unknown. This study aimed to compare the risk of VTE recurrence between patients with COVID-19- and surgery-associated VTE.
A prospective observational single-center study was performed including consecutive patients diagnosed with VTE in a tertiary hospital from January 2020 to May 2022 and followed up for at least 90 days. Baseline characteristics, clinical presentation, and outcomes were assessed. The incidence of VTE recurrence, bleeding, and death was compared between both groups.
A total of 344 patients were included in the study: 111 patients with surgery-associated VTE and 233 patients with COVID-19-associated VTE. Patients with COVID-19-associated VTE were more frequently men (65.7% vs 48.6%, p = 0.003). VTE recurrence was 3% among COVID-19 patients and 5.4% among surgical patients, with no significant differences (p = 0.364). The incidence rate of recurrent VTE was 1.25 per 1000 person-months in COVID-19 patients and 2.29 person-months in surgical patients, without significant differences (p = 0.29). In the multivariate analysis, COVID-19 was associated with higher mortality (HR 2.34; 95% CI 1.19-4.58), but not with a higher risk of recurrence (HR 0.52; 95% CI 0.17-1.61). No differences were found in recurrence in the multivariate competing risk analysis (SHR 0.82; 95% CI 0.40-2.05).
In patients with COVID-19 and surgery-associated VTE, the risk of recurrence was low, with no differences between both groups.
A prospective observational single-center study was performed including consecutive patients diagnosed with VTE in a tertiary hospital from January 2020 to May 2022 and followed up for at least 90 days. Baseline characteristics, clinical presentation, and outcomes were assessed. The incidence of VTE recurrence, bleeding, and death was compared between both groups.
A total of 344 patients were included in the study: 111 patients with surgery-associated VTE and 233 patients with COVID-19-associated VTE. Patients with COVID-19-associated VTE were more frequently men (65.7% vs 48.6%, p = 0.003). VTE recurrence was 3% among COVID-19 patients and 5.4% among surgical patients, with no significant differences (p = 0.364). The incidence rate of recurrent VTE was 1.25 per 1000 person-months in COVID-19 patients and 2.29 person-months in surgical patients, without significant differences (p = 0.29). In the multivariate analysis, COVID-19 was associated with higher mortality (HR 2.34; 95% CI 1.19-4.58), but not with a higher risk of recurrence (HR 0.52; 95% CI 0.17-1.61). No differences were found in recurrence in the multivariate competing risk analysis (SHR 0.82; 95% CI 0.40-2.05).
In patients with COVID-19 and surgery-associated VTE, the risk of recurrence was low, with no differences between both groups.
摘要：
背景：近期手术是静脉血栓栓塞症（VTE）的主要短暂性危险因素，因为停药后VTE复发的风险较低。另一方面,COVID-19相关VTE患者的VTE复发风险未知.这项研究旨在比较COVID-19和手术相关VTE患者的VTE复发风险。
方法：进行了一项前瞻性观察性单中心研究，纳入2020年1月至2022年5月在三级医院诊断为VTE的连续患者，并随访至少90天。基线特征，临床表现,并对结果进行了评估。VTE复发的发生率，出血,并比较两组的死亡情况。
结果：共344例患者纳入研究：111例手术相关VTE患者和233例COVID-19相关VTE患者。患有COVID-19相关VTE的患者更常见的是男性(65.7%vs48.6%，p=0.003)。COVID-19患者的VTE复发率为3%，手术患者为5.4%，无显著性差异(p=0.364)。COVID-19患者VTE复发发生率为1.25/1000人月，手术患者为2.29人月，无显著差异(p=0.29)。在多变量分析中，COVID-19与较高的死亡率相关(HR2.34;95%CI1.19-4.58)，但复发风险较高(HR0.52;95%CI0.17-1.61)。在多变量竞争风险分析中没有发现复发的差异（SHR0.82;95％CI0.40-2.05）。
结论：在患有COVID-19和手术相关静脉血栓栓塞的患者中，复发的风险很低,两组之间没有差异。
方法：进行了一项前瞻性观察性单中心研究，纳入2020年1月至2022年5月在三级医院诊断为VTE的连续患者，并随访至少90天。基线特征，临床表现,并对结果进行了评估。VTE复发的发生率，出血,并比较两组的死亡情况。
结果：共344例患者纳入研究：111例手术相关VTE患者和233例COVID-19相关VTE患者。患有COVID-19相关VTE的患者更常见的是男性(65.7%vs48.6%，p=0.003)。COVID-19患者的VTE复发率为3%，手术患者为5.4%，无显著性差异(p=0.364)。COVID-19患者VTE复发发生率为1.25/1000人月，手术患者为2.29人月，无显著差异(p=0.29)。在多变量分析中，COVID-19与较高的死亡率相关(HR2.34;95%CI1.19-4.58)，但复发风险较高(HR0.52;95%CI0.17-1.61)。在多变量竞争风险分析中没有发现复发的差异（SHR0.82;95％CI0.40-2.05）。
结论：在患有COVID-19和手术相关静脉血栓栓塞的患者中，复发的风险很低,两组之间没有差异。
