Risk Factors for Pulmonary Embolism in Patients with Paralysis and Deep Venous Thrombosis

Background. Venous thromboembolism is a frequent complication and an important cause of death in patients with paralysis. We aimed to investigate predictors of pulmonary embolism (PE) and the impact of PE on the survival of patients with paralysis in comparison to those with deep venous thrombosis o...

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Autores principales:	Karsten Keller, Jens Wöllner, Volker H. Schmitt, Mir A. Ostad, Ingo Sagoschen, Thomas Münzel, Christine Espinola-Klein, Lukas Hobohm
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	paralysis stroke mortality spinal cord injury pulmonary embolism Medicine R
Acceso en línea:	https://doaj.org/article/3803a5cad0bb4c669973f3898e73ada8
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spelling	oai:doaj.org-article:3803a5cad0bb4c669973f3898e73ada82021-11-25T18:02:33ZRisk Factors for Pulmonary Embolism in Patients with Paralysis and Deep Venous Thrombosis10.3390/jcm102254122077-0383https://doaj.org/article/3803a5cad0bb4c669973f3898e73ada82021-11-01T00:00:00Zhttps://www.mdpi.com/2077-0383/10/22/5412https://doaj.org/toc/2077-0383Background. Venous thromboembolism is a frequent complication and an important cause of death in patients with paralysis. We aimed to investigate predictors of pulmonary embolism (PE) and the impact of PE on the survival of patients with paralysis in comparison to those with deep venous thrombosis or thrombophlebitis (DVT). Methods: Patients were selected by screening the German nationwide inpatient sample (2005–2017) for paralysis, and were stratified for venous thromboembolism (VTE) and the VTE-sub-entity PE (ICD-code I26). Impact of PE on mortality and predictors for PE were analyzed. Results: Overall, 7,873,769 hospitalizations of patients with paralysis were recorded in Germany 2005–2017, of whom 1.6% had VTE and 7.0% died. While annual hospitalizations increased (2005: 520,357 to 2017: 663,998) (β 12,421 (95% CI 10,807 to 14,034), <i>p</i> < 0.001), in-hospital mortality decreased from 7.5% to 6.7% (β −0.08% (95% CI −0.10% to −0.06%), <i>p</i> < 0.001). When focusing on 82,558 patients with paralysis hospitalized due to VTE (51.8% females; 58.3% aged ≥ 70 years) in 2005–2017, in-hospital mortality was significantly higher in patients with paralysis and PE than in those with DVT only (23.8% vs. 6.3%, <i>p</i> < 0.001). Cancer (OR 2.18 (95% CI 2.09–2.27), <i>p</i> < 0.001), heart failure (OR 1.83 (95% CI 1.76–1.91), <i>p</i> < 0.001), COPD (OR 1.63 (95% CI 1.53–1.72), <i>p</i> < 0.001) and obesity (OR 1.42 (95% CI 1.35–1.50), <i>p</i> < 0.001) were associated with PE. PE (OR 4.28 (95% CI 4.07–4.50), <i>p</i> < 0.001) was a strong predictor of in-hospital mortality. Conclusions: In Germany, annual hospitalizations of patients with paralysis increased in 2005–2017, in whom VTE and especially PE substantially affected in-hospital mortality. Cancer, heart failure, COPD, obesity and acute paraplegia were risk factors of PE.Karsten KellerJens WöllnerVolker H. SchmittMir A. OstadIngo SagoschenThomas MünzelChristine Espinola-KleinLukas HobohmMDPI AGarticleparalysisstrokemortalityspinal cord injurypulmonary embolismMedicineRENJournal of Clinical Medicine, Vol 10, Iss 5412, p 5412 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	paralysis stroke mortality spinal cord injury pulmonary embolism Medicine R
spellingShingle	paralysis stroke mortality spinal cord injury pulmonary embolism Medicine R Karsten Keller Jens Wöllner Volker H. Schmitt Mir A. Ostad Ingo Sagoschen Thomas Münzel Christine Espinola-Klein Lukas Hobohm Risk Factors for Pulmonary Embolism in Patients with Paralysis and Deep Venous Thrombosis
description	Background. Venous thromboembolism is a frequent complication and an important cause of death in patients with paralysis. We aimed to investigate predictors of pulmonary embolism (PE) and the impact of PE on the survival of patients with paralysis in comparison to those with deep venous thrombosis or thrombophlebitis (DVT). Methods: Patients were selected by screening the German nationwide inpatient sample (2005–2017) for paralysis, and were stratified for venous thromboembolism (VTE) and the VTE-sub-entity PE (ICD-code I26). Impact of PE on mortality and predictors for PE were analyzed. Results: Overall, 7,873,769 hospitalizations of patients with paralysis were recorded in Germany 2005–2017, of whom 1.6% had VTE and 7.0% died. While annual hospitalizations increased (2005: 520,357 to 2017: 663,998) (β 12,421 (95% CI 10,807 to 14,034), <i>p</i> < 0.001), in-hospital mortality decreased from 7.5% to 6.7% (β −0.08% (95% CI −0.10% to −0.06%), <i>p</i> < 0.001). When focusing on 82,558 patients with paralysis hospitalized due to VTE (51.8% females; 58.3% aged ≥ 70 years) in 2005–2017, in-hospital mortality was significantly higher in patients with paralysis and PE than in those with DVT only (23.8% vs. 6.3%, <i>p</i> < 0.001). Cancer (OR 2.18 (95% CI 2.09–2.27), <i>p</i> < 0.001), heart failure (OR 1.83 (95% CI 1.76–1.91), <i>p</i> < 0.001), COPD (OR 1.63 (95% CI 1.53–1.72), <i>p</i> < 0.001) and obesity (OR 1.42 (95% CI 1.35–1.50), <i>p</i> < 0.001) were associated with PE. PE (OR 4.28 (95% CI 4.07–4.50), <i>p</i> < 0.001) was a strong predictor of in-hospital mortality. Conclusions: In Germany, annual hospitalizations of patients with paralysis increased in 2005–2017, in whom VTE and especially PE substantially affected in-hospital mortality. Cancer, heart failure, COPD, obesity and acute paraplegia were risk factors of PE.
format	article
author	Karsten Keller Jens Wöllner Volker H. Schmitt Mir A. Ostad Ingo Sagoschen Thomas Münzel Christine Espinola-Klein Lukas Hobohm
author_facet	Karsten Keller Jens Wöllner Volker H. Schmitt Mir A. Ostad Ingo Sagoschen Thomas Münzel Christine Espinola-Klein Lukas Hobohm
author_sort	Karsten Keller
title	Risk Factors for Pulmonary Embolism in Patients with Paralysis and Deep Venous Thrombosis
title_short	Risk Factors for Pulmonary Embolism in Patients with Paralysis and Deep Venous Thrombosis
title_full	Risk Factors for Pulmonary Embolism in Patients with Paralysis and Deep Venous Thrombosis
title_fullStr	Risk Factors for Pulmonary Embolism in Patients with Paralysis and Deep Venous Thrombosis
title_full_unstemmed	Risk Factors for Pulmonary Embolism in Patients with Paralysis and Deep Venous Thrombosis
title_sort	risk factors for pulmonary embolism in patients with paralysis and deep venous thrombosis
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/3803a5cad0bb4c669973f3898e73ada8
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Risk Factors for Pulmonary Embolism in Patients with Paralysis and Deep Venous Thrombosis

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