■2019年冠状病毒病(COVID-19)肺炎患者的静脉血栓栓塞(VTE)风险升高,而非COVID-19肺炎患者与VTE相关的危险因素仍有待定义。本研究旨在根据系统评价和荟萃分析(PRISMA)指南的首选报告项目进行荟萃分析和系统评价,以确定COVID-19前期肺炎患者VTE的潜在危险因素。
■PubMed,EMBASE,搜索了Cochrane图书馆.两名审稿人进行了筛选,全文回顾,和提取。估计风险因素和比值比(OR)。
■在确定的595篇文章中,纳入了六项研究。汇总分析提示年龄≥60岁[OR=2.75,95%置信区间(CI):2.55-2.97,P<0.001],机械通气(MV)(OR=9.48,95%CI:8.24-10.91,P<0.001),高血压(OR=1.41,95%CI:1.09-1.83,P=0.010),糖尿病(OR=1.49,95%CI:1.36-1.64,P<0.001),心力衰竭(OR=3.15,95%CI:1.05-9.41,P=0.040)和癌症(OR=2.86,95%CI:2.07-3.95,P<0.001)与肺炎患者深静脉血栓形成的高风险相关.年龄≥60岁时(OR=2.46,95%CI:2.21~2.73,P<0.001),细菌性肺炎(OR=3.80,95%CI:1.65-8.73,P=0.002),高脂血症(OR=1.55,95%CI:1.00-2.41,P=0.049),心力衰竭(OR=2.70,95%CI:2.05-3.56,P<0.001),慢性阻塞性肺疾病(OR=4.73,95%CI:3.11-7.17,P<0.001)和癌症(OR=2.90,95%CI:2.39-3.53,P<0.001)是肺炎患者肺栓塞的危险因素。
■非COVID-19肺炎患者,尤其是那些高龄的人,MV,心血管合并症或癌症,住院期间需要个性化管理。我们的发现有助于完善肺炎患者的风险预测模型和进一步的风险分层。
UNASSIGNED: Elevated risk of venous thromboembolism (VTE) in patients with coronavirus disease 2019 (COVID-19) pneumonia has been recognized, while the risk factors associated with VTE in patients with non-COVID-19 pneumonia remain to be defined. This study aimed to conduct a meta-analysis and systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to identify potential risk factors for VTE in patients with pneumonia from the pre-COVID-19 era.
UNASSIGNED: PubMed, EMBASE, and Cochrane Library were searched. Two reviewers performed screening, full-text review, and extraction. Risk factors and odds ratio (OR) were estimated.
UNASSIGNED: Of 595 articles identified, six studies were included. Pooled analysis suggested that age ≥60 years [OR =2.75, 95% confidence interval (CI): 2.55-2.97, P<0.001], mechanical ventilation (MV) (OR =9.48, 95% CI: 8.24-10.91, P<0.001), hypertension (OR =1.41, 95% CI: 1.09-1.83, P=0.010), diabetes (OR =1.49, 95% CI: 1.36-1.64, P<0.001), heart failure (OR =3.15, 95% CI: 1.05-9.41, P=0.040) and cancer (OR =2.86, 95% CI: 2.07-3.95, P<0.001) were associated with higher risk for deep vein thrombosis in patients with pneumonia. While age ≥60 years (OR =2.46, 95% CI: 2.21-2.73, P<0.001), bacterial pneumonia (OR =3.80, 95% CI: 1.65-8.73, P=0.002), hyperlipidemia (OR =1.55, 95% CI: 1.00-2.41, P=0.049), heart failure (OR =2.70, 95% CI: 2.05-3.56, P<0.001), chronic obstructive pulmonary disease (OR =4.73, 95% CI: 3.11-7.17, P<0.001) and cancer (OR =2.90, 95% CI: 2.39-3.53, P<0.001) were risk factors for pulmonary embolism in patients with pneumonia.
UNASSIGNED: Patients with non-COVID-19 pneumonia, particularly those with advanced age, MV, cardiovascular comorbidities or cancer, warrant individualized management during hospitalization. Our findings could contribute to refining risk prediction models and further risk stratification for VTE in patients with pneumonia in clinical practice.