Rate and impact of venous thromboembolism in patients with ST-segment elevation myocardial infarction: Analysis of the Nationwide Inpatient Sample database 2003-2013

被引:3
作者
Al-Ogaili, Ahmed [1 ]
Ayoub, Ali [1 ]
Quintero, Luis Diaz [2 ]
Torres, Christian [1 ]
Fuentes, Harry E. [3 ]
Fugar, Setri [4 ]
Kolkailah, Ahmed A. [1 ]
Dakkak, Wael [1 ]
Tafur, Alfonso J. [5 ]
Yadav, Neha [6 ]
机构
[1] John H Stroger Jr Hosp Cook Cty, Dept Med, 1900 West Polk St, Chicago, IL 60612 USA
[2] NorthShore Univ HealthSyst, Dept Med, Evanston, IL USA
[3] Mayo Clin, Div Hematol Oncol, Rochester, MN USA
[4] Rush Univ, Div Cardiol, Chicago, IL 60612 USA
[5] NorthShore Univ HealthSyst, Dept Med, Cardiol Vasc Med, Evanston, IL USA
[6] John H Stroger Jr Hosp Cook Cty, Div Cardiol, Chicago, IL USA
关键词
coronary artery disease; deep vein thrombosis (DVT); myocardial infarction; National Inpatient Sample (NIS); pulmonary embolism (PE); venous thromboembolism (VTE); CANCER-PATIENTS; UNITED-STATES; OUTCOMES; MANAGEMENT; RISK; ATHEROSCLEROSIS; CLOPIDOGREL; SURGERY; ASPIRIN; THERAPY;
D O I
10.1177/1358863X19833451
中图分类号
R6 [外科学];
学科分类号
1002 ; 100210 ;
摘要
Venous thromboembolism (VTE) and coronary artery disease are major health issues that cause substantial morbidity and mortality. New data have emerged suggesting that these two conditions could have a close relationship. Thus, we sought to determine the trends in annual rate of VTE occurrence in patients with ST-segment elevation myocardial infarction (STEMI) and measure its impact on in-hospital mortality, bleeding complications, and cost and length of hospitalization. We queried the 2003-2013 Nationwide Inpatient Sample databases to identify adults with primary diagnosis of STEMI. VTE events were then allocated. Inpatient outcomes of patients with VTE were compared to those without VTE. Out of 2,495,757 hospitalizations for STEMI, VTE was diagnosed in 25,149 (1%) hospitalizations. Patients who experienced VTE were older (mean age: 67.5 vs 64.8, p < 0.01) and had a higher proportion of black patients (10.1% vs 7.7%, p < 0.001) and females (40.1% vs 35%, p < 0.001) compared to patients without VTE. There was an increasing trend in the rate of VTE during the study period (2003: 0.8% vs 2013: 1.0%, p < 0.001). Patients with VTE had a prolonged hospitalization (median: 9 vs 3 days, p < 0.001), increased cost, higher risk of gastrointestinal bleeding (OR: 2.13, p < 0.001), intracranial hemorrhage (OR: 2.14, p < 0.001), blood transfusions (OR: 1.94, p < 0.001), and mortality (OR: 1.39, p < 0.001). The rate of VTE occurrence in patients with STEMI in our study was 10 per 1000 admissions. VTE was associated with more bleeding complications, longer hospital stays, higher costs, and mortality. These findings suggest that a more aggressive approach for VTE prophylaxis may be warranted in this population.
引用
收藏
页码:341 / 348
页数:8
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