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Risk of venous thromboembolism in people admitted to hospital with selected immune-mediated diseases: record-linkage study

机译:患有选定免疫介导的疾病的人们入院静脉血栓栓塞的风险:记录连锁研究

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Background Venous thromboembolism (VTE) is a common complication during and after a hospital admission. Although it is mainly considered a complication of surgery, it often occurs in people who have not undergone surgery, with recent evidence suggesting that immune-mediated diseases may play a role in VTE risk. We, therefore, decided to study the risk of deep vein thrombosis (DVT) and pulmonary embolism (PE) in people admitted to hospital with a range of immune-mediated diseases. Methods We analysed databases of linked statistical records of hospital admissions and death certificates for the Oxford Record Linkage Study area (ORLS1:1968 to 1998 and ORLS2:1999 to 2008) and the whole of England (1999 to 2008). Rate ratios for VTE were determined, comparing immune-mediated disease cohorts with comparison cohorts. Results Significantly elevated risks of VTE were found, in all three populations studied, in people with a hospital record of admission for autoimmune haemolytic anaemia, chronic active hepatitis, dermatomyositis/polymyositis, type 1 diabetes mellitus, multiple sclerosis, myasthenia gravis, myxoedema, pemphigus/pemphigoid, polyarteritis nodosa, psoriasis, rheumatoid arthritis, Sjogren's syndrome, and systemic lupus erythematosus. Rate ratios were considerably higher for some of these diseases than others: for example, for systemic lupus erythematosus the rate ratios were 3.61 (2.36 to 5.31) in the ORLS1 population, 4.60 (3.19 to 6.43) in ORLS2 and 3.71 (3.43 to 4.02) in the England dataset. Conclusions People admitted to hospital with immune-mediated diseases may be at an increased risk of subsequent VTE. Our findings need independent confirmation or refutation; but, if confirmed, there may be a role for thromboprophylaxis in some patients with these diseases.
机译:背景技术静脉血栓栓塞(VTE)是医院入院期间和之后的常见并发症。虽然主要被认为是手术的并发症,但它通常发生在没有经过手术的人中,最近的证据表明免疫介导的疾病可能在VTE风险中发挥作用。因此,我们决定研究深静脉血栓形成(DVT)和肺栓塞(PE)的人们在患有一系列免疫介导的疾病的人们中。方法对牛津记录联动研究区的医院入学和死亡证明的联系统计记录(ORLS1:1968至1998年和ORLS2:1999至2008)分析了数据库,以及整个英格兰(1999年至2008年)。测定VTE的速率比,比较免疫介导的疾病队列与比较队列。结果发现VTE的风险显着提高,在所有三个群体中都有历史,在患有自身免疫性血液溶血性贫血,慢性活性肝炎,Dermatomyositis / Polymyositis,1型糖尿病,多发性硬化,肌炎肌肉,Myxoedema,Pemphigus的人口/ Pemphigoid,PolyoRisitis Nodosa,牛皮癣,类风湿性关节炎,Sjogren综合征和系统性红斑狼疮。这些疾病的率比其他疾病的速率比率相当高:例如,对于Systemic Lupus红斑狼疮,速率比在Orls1人口中为3.61(2.36至5.31),Orls2和3.71的3.60(3.19至6.43)(3.43至4.02)在英格兰数据集。结论患有免疫介导的疾病入境的人可能会增加后续VTE的风险。我们的调查结果需要独立的确认或驳斥;但是,如果确认,某些患者可能存在对这些疾病的一些患者的血栓血管缺陷作用。

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