Incidence and risk factors of venous thrombotic events in patients with interstitial lung disease during hospitalization

Abstract

Background Studies on the incidence of venous thromboembolism (VTE) events in patients with interstitial lung disease (ILD) are limited and the results are inconsistent. The aim of this research was to investigate the incidence and risk factors of VTE in ILD during hospitalization. Materials and methods In this retrospective, cross-sectional, observational study, a total of 5009 patients diagnosed with ILD from January 2016 to March 2022 in our hospital were retrospectively included. In ILD patients, VTE including pulmonary thromboembolism (PTE) and deep vein thrombosis (DVT) were screened from the electronic medical record system. Diagnosis of PTE and DVT were performed by CT pulmonary angiography (CTPA), CTV or ultrasound. And then the incidence and risk factors of VTE in different types of ILD were assessed. Results Among 5009 patients with ILD, VTE was detected in 129 (2.6%) patients, including 15(0.3%) patients with both PTE and DVT, 34 (0.7%) patients with PTE and 80 (1.6%) patients with DVT. 85.1% of patients with APE were in the intermediate-low risk group. The incidence of VTE in Anti-Neutrophil Cytoplasmic Antibodies -associated vasculitis related ILD (ANCA-AV-ILD), hypersensitivity pneumonitis and idiopathic pulmonary fibrosis (IPF) respectively was 7.9% and 3.6% and 3.5%. In patients with connective tissue disease-associated ILD (CTD-ILD), the incidence of VTE, DVT, PTE, combined PTE and DVT respectively was 3.0%, 2.3%, 0.4% and 0.3%. Among the various risk factors, different ILD categories, age ≥ 80 years (OR 4.178, 95% CI 2.097–8.321, P < 0.001), respiratory failure (OR 2.382, 95% CI 1.533–3.702, P < 0.001) and varicose veins (OR 3.718, 95% CI 1.066–12.964, P = 0.039) were independent risk factors of VTE. The incidence of VTE in patients with ILD increased with the length of time in hospital from 2.2% (< 7 days) to 6.4% (> 21 days). Conclusion The incidence of VTE during hospitalization in ILD patients was 2.6%, with a 1.6% incidence of DVT, higher than the 0.7% incidence of PTE. Advanced age, ILD categories, respiratory failure and varicose veins as independent risk factors for the development of VTE should be closely monitored.

Risk assessment scales to predict risk of lower extremity deep vein thrombosis among multiple trauma patients: A prospective cohort study

“…However, the incidence of lower extremity DVT in trauma patients who have received thromboprophylaxis was still as high as 12 ~ 65%[26]. Sun et al [27] found that, even with conventional prevention, the incidence of DVT in multiple trauma patients was as high as 42.08%, of which the incidence of proximal DVT was 6.56% and that of distal DVT was 35.52%. The DVT prevalence in this study was similar to others.…”

Risk assessment scales to predict risk of lower extremity deep vein thrombosis among multiple trauma patients: a prospective cohort study

“…However, the incidence of lower extremity DVT in trauma patients who have received thromboprophylaxis was still as high as 12 ~ 65% [ 23 ]. Sun et al [ 24 ] found that, even with conventional prevention, the incidence of DVT in multiple trauma patients was as high as 42.08%, of which the incidence of proximal DVT was 6.56% and that of distal DVT was 35.52%. The DVT prevalence in this study was similar to others.…”

Under the dual effect of inflammation and pulmonary fibrosis, CTD-ILD patients possess a greater susceptibility to VTE

“…A prospective clinical study found that the incidence of VTE in patients with CTD-ILD was 20% [ 11 ]. Although the subtype of ILD is an independent risk factor affecting the development of VTE in patients with ILD [ 12 ], existing clinical studies on the occurrence of VTE in patients with ILD have mainly focused on IPF, and there is a lack of large-scale multicenter clinical statistical studies on the clinical characteristics and risk factors for the occurrence of VTE in patients with CTD-ILD, and exploratory studies at home and abroad on the mechanism of thrombosis in this type of patients are equally inadequate.…”