Analysis Of Risk Factors For Deep Vein Thrombosis With Pulmonary Embolism

PurposeThrough statistical analysis of relevant factors for patients with deep venous thrombosis（DVT）combined with pulmonary embolism（PE）,risk factors can be obtained,so as to formulate reasonable treatment schemes for DVT patients with risk factors for PE and prevent the occurrence of PE.MethodsA total of 161 patients with DVT could be diagnosed and collected,from January2015 to March 2019,in the branch of the third central hospital of tianjin.Among them,12 cases conformed to the exclusion criteria（2 cases with long-term oral contraceptives,1 case with pregnant women,5 cases with incomplete medical records,4 cases with suspected PE,but without diagnosis of CTPA or pulmonary ECT）.Finally,a total of 149 patients were selected.Crowd of basic features of patients and related factors,including age,gender,malignant tumor（tumor type,whether there is a transfer,the current treatment）,which happen in recent trauma/surgery history（VTE）more than 90 days before the diagnosis,the recent fracture within 90days before confirmed（VTE）,decreased activity（stay in bed for three days or more）,always venous thromboembolism（venous thmmboembolism,History of VTE）,obesity（BMI of 30 or higher）and autoimmune diseases,including rheumatoid arthritis,systemic lupus erythematosus（sle）and sjogren’s syndrome),known Yi Shuan syndrome（hereditary antithrombin III、PS、PC reduce）,acute infection（confirmed within one week before DVT clear history including respiratory infection,infection of urinary tract infection,central venous catheter related infections,monitoring indicators measuring white blood cells,neutrophils,c-reactive protein,calcitonin is more than normal）,is being treated for a hormone（application of glucocorticoid medications within 90 days,Including injection,oral administration and inhalation）,smoking（≥400 years with no significant history of smoking cessation in 1 year before onset）,and heart failure(in line with the diagnostic criteria in"Chinese guidelines for the diagnosis and treatment of heart failure 2014"^[1]).were retrospectively analyzed.Shapiro-Wilk was first inspected for age variable,again t test used to pure DVT and DVT combined PE group,the single factor analysis for other related research factors,chi-square test for count data,and unconditioned Logstic multiple factors analysis for the significant differences between the two groups of factors.Finally,the independent risk factors of PE in DVT merger were obtained.ResultsMalignant tumor,past history of VTE,acute infection,smoking,heart failure and other relevant factors affect the incidence of DVT with PE,in the near future/surgical trauma history,recent fracture,decreased activity,stay in bed for three days or more),obesity（BMI of 30 or higher）and autoimmune diseases,known Thrombophilia,application of glucocorticoid treatment the incidence of DVT patients complicated with PE and the influence factors,such as no significant correlation.Then,non-conditional multivariate Logistic regression analysis was carried out on 5subjects including malignant tumor,previous history of VTE,acute infection,smoking,and heart failure,and the results showed that malignant tumor（OR=5.956,P=0.014）,previous history of VTE（OR=10.396,P=0.002）,and acute infection（OR=6.148,P=0.008）were independent risk factors for PE in DVT patients.ConclusionMalignant tumor,previous history of VTE,acute infection,smoking,heart failureand other related factors were associated with the occurrence of PE in DVT patients.Age,gender,in the near future/surgical trauma history,recent fracture,decreased activity（stay in bed for three days or more）,obesity（BMI of 30 or higher）and autoimmune diseases,known Thrombophilia,and being treated for a hormone,were not associated with the occurrence of PE in DVT patients.Moreover,malignant tumor,previous history of VTE and acute infection were independent risk factors for DVT complicated with PE.