■肺栓塞(PE)是一种严重且可能危及生命的疾病,需要及时诊断和治疗。识别危险因素和诊断标记可以帮助早期发现和管理这种情况。
这项病例对照研究检查了2020年深圳康宁医院精神病院收治的10077名患者。其中,65例患者被诊断为PE,包括50个新病例。在对对照组进行生存抽样并进行年龄和性别匹配后,该研究包括41例新PE病例和41例年龄和性别匹配的对照.人口统计数据,合并症,从电子记录中提取药物使用情况。进行条件逻辑回归分析以确定每个预测因子与PE风险之间的关联。此外,评估d-二聚体诊断工具的敏感性和特异性.
■在单变量条件逻辑回归中,积极的酒精中毒与较高的PE风险相关(OR=3.675,95%CI1.02-13.14,P=0.046)。物理约束史(OR=4.33,95%CI1.24-15.21,P=0.022)和化学约束史(OR4.67,95%CI1.34-16.24,p=0.015)也增加了PE风险,使用苯二氮卓类药物也是如此(OR=3.33,95%CI1.34-8.30,P=0.010)。相反,入院前精神药物治疗与PE风险较低相关(OR=0.07,95%CI0.01-0.59,P=0.013).逐步多变量前向条件回归确定了PE风险较高的精神病患者的两个子集:入院时无药物治疗的新精神病病例,以及入院时没有药物治疗的患者开始服用抗精神病药物和苯二氮卓类药物。D-二聚体诊断工具,由Youden指数确定的最佳阈值为570ng/ml(J统计量为0.6098),检测PE的灵敏度为73.17%,特异性为87.80%,AUC为0.833(95%CI:0.735-0.906)。
■我们的研究结果表明,克制的历史,酗酒,抗精神病药物和苯二氮卓类药物的使用是精神病住院患者PE的重要预测因素。相反,入院时的精神药物治疗可能与较低的PE风险有关.d-二聚体诊断工具对精神病住院患者的PE筛查显示出良好的价值。这些预测因子和诊断指标可以帮助临床医生识别高危患者并实施适当的预防策略。
UNASSIGNED: Pulmonary embolism (PE) is a serious and potentially life-threatening condition that requires prompt diagnosis and treatment. Identifying risk factors and diagnostic markers can aid in the early detection and management of this condition.
UNASSIGNED: This case-control
study examined 10,077 patients admitted to Shenzhen Kangning Hospital\'s psychiatry facility in 2020. Among these, 65 patients were diagnosed with PE, including 50 new cases. After survival sampling for controls and age-and-gender matching, the
study included 41 new PE cases and 41 age-and-gender-matched controls. Data on demographics, comorbidities, and medication use were extracted from electronic records. Conditional logistic regression analyses were performed to determine the association between each predictor and PE risk. Additionally, the sensitivity and specificity of the d-dimer diagnostic tool were assessed.
UNASSIGNED: In univariable conditional logistic regression, active alcoholism was associated with a higher PE risk (OR=3.675, 95% CI 1.02-13.14, P=0.046). A history of physical restraint (OR=4.33, 95% CI 1.24-15.21, P=0.022) and chemical restraint (OR 4.67, 95% CI 1.34-16.24, p=0.015) also increased PE risk, as did benzodiazepine use (OR=3.33, 95% CI 1.34-8.30, P=0.010). Conversely, psychotropic medication before admission was associated with a lower risk of PE (OR=0.07, 95% CI 0.01-0.59, P=0.013). Stepwise multivariable forward conditional regression identified two subsets of psychiatric patients at higher risk of PE: new psychiatric cases without medication at admission who were chemically restrained, and cases without medication at admission who were started on antipsychotics and benzodiazepines. The d-dimer diagnostic tool, with an optimal threshold of 570 ng/ml determined by the Youden index (J statistic of 0.6098), showed a sensitivity of 73.17% and specificity of 87.80% for detecting PE, with an AUC of 0.833 (95% CI: 0.735-0.906).
UNASSIGNED: Our findings suggest that a history of restraint, alcoholism, and the use of antipsychotics and benzodiazepines are important predictors of PE in psychiatric inpatients. Conversely, psychotropic medications at admission may be linked to a lower PE risk. The d-dimer diagnostic tool shows good value for screening PE in psychiatric inpatients. These predictors and diagnostic markers could help clinicians identify high-risk patients and implement appropriate prevention strategies.