OBJECTIVE:Provoked deep venous thrombosis (DVT) is precipitated by a specific event. This paper compares the characteristics of provoked DVT in patients with transient risk (TR) factors and patients with continuous risk (CR) factors.
METHODS:A retrospective review of records of all consecutive patients diagnosed with DVT between January 2013 and August 2014 was performed. Patients with provoked DVT were included in the TR group if the provoking event resolved in 2 weeks and they did not have ongoing risk of thrombosis. Patients in the CR group had a provoked DVT with ongoing risk of thrombosis due to individual factors deemed to be ongoing risks of thrombosis, such as cancer, hypercoagulable disorder, and prolonged immobilization. Demographics, risk factors, association with pulmonary embolism (PE) and its severity, risk of recurrent venous thromboembolism (VTE), and mortality were compared between the two groups.
RESULTS:A total of 838 patients were diagnosed with DVT, and 50.7% (425) were provoked. There were 127 (29.9%) patients with TR and 298 (70.1%) with CR. TR patients were younger (60.4 ± 16.3 vs 65.9 ± 16.0; P = .001). TR was more likely to be provoked by surgery (70.9% vs 55.4%; P = .003), whereas CR was more likely to be provoked by immobilization (21.5% vs 12.6%; P = .032). CR patients were affected by cancer (48.7%) and hypercoagulable disorders (4.4%). TR patients were more likely to have calf DVTs (36.2% vs 26.2%; P = .047). There was a trend toward lower association with PE on presentation in TR (17.3% vs 21.1%; P = .072), but that did not reach statistical significance. However, TR factors were more likely to be associated with low-risk PE compared with CR factors (30.2% vs 54.6%; P = .040). After mean follow-up of 7.2 months, CR had higher risk of recurrent VTE (14.0% vs 6.8%; P = .045) and mortality (23.5% vs 7.1%; P < .0001).
CONCLUSIONS:Provoked DVT with CR factors affects older patients and is associated with high recurrence of VTE and mortality compared with provoked DVT with TR factors.
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【Characteristics of provoked deep venous thrombosis in a tertiary care center.].
【三级护理中心引起的深静脉血栓形成的特征。】
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DOI：10.1016/j.jvsv.2017.02.006文章类型：杂志文章
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目的：诱发深静脉血栓形成（DVT）是由特定事件引起的。本文比较了短暂风险（TR）因子和持续风险（CR）因子引起的DVT的特征。
方法：回顾性分析2013年1月至2014年8月间所有诊断为DVT的连续患者的病历。如果挑衅事件在2周内解决并且他们没有持续的血栓形成风险，则将挑衅性DVT的患者纳入TR组。 CR组的患者患有诱发性DVT，具有持续的血栓形成风险，原因是被认为是持续的血栓形成风险的个体因素，例如癌症，高凝性疾病和长时间的固定。比较了两组的人口统计学，危险因素，与肺栓塞（PE）的关联及其严重性，复发性静脉血栓栓塞（VTE）的风险和死亡率。
结果：总共诊断为DVT的838例患者，引起了50.7％（425）的挑衅。有127名（29.9％）的TR患者和298名（70.1％）的CR患者。 TR患者较年轻（60.4±16.3 vs 65.9±16.0; P = .001）。 TR更有可能由手术引起（70.9％vs 55.4％; P = .003），而CR更有可能由固定引起（21.5％vs 12.6％; P = .032）。 CR患者受癌症（48.7％）和高凝性疾病（4.4％）的影响。 TR患者更有可能患有小腿深静脉血栓（36.2％vs 26.2％; P = .047）。在TR中出现与PE的关联性较低的趋势（17.3％对21.1％; P = .072），但这没有统计学意义。然而，与CR因子相比，TR因子更可能与低风险PE相关（30.2％vs 54.6％; P = .040）。平均随访7.2个月后，CR复发VTE（14.0％vs 6.8％; P = .045）和死亡率（23.5％vs 7.1％; P <.0001）的风险更高。
结论：诱发性DVT伴CR因素会影响老年患者，与诱发性DVT伴TR因素相比具有较高的VTE复发率和死亡率。
方法：回顾性分析2013年1月至2014年8月间所有诊断为DVT的连续患者的病历。如果挑衅事件在2周内解决并且他们没有持续的血栓形成风险，则将挑衅性DVT的患者纳入TR组。 CR组的患者患有诱发性DVT，具有持续的血栓形成风险，原因是被认为是持续的血栓形成风险的个体因素，例如癌症，高凝性疾病和长时间的固定。比较了两组的人口统计学，危险因素，与肺栓塞（PE）的关联及其严重性，复发性静脉血栓栓塞（VTE）的风险和死亡率。
结果：总共诊断为DVT的838例患者，引起了50.7％（425）的挑衅。有127名（29.9％）的TR患者和298名（70.1％）的CR患者。 TR患者较年轻（60.4±16.3 vs 65.9±16.0; P = .001）。 TR更有可能由手术引起（70.9％vs 55.4％; P = .003），而CR更有可能由固定引起（21.5％vs 12.6％; P = .032）。 CR患者受癌症（48.7％）和高凝性疾病（4.4％）的影响。 TR患者更有可能患有小腿深静脉血栓（36.2％vs 26.2％; P = .047）。在TR中出现与PE的关联性较低的趋势（17.3％对21.1％; P = .072），但这没有统计学意义。然而，与CR因子相比，TR因子更可能与低风险PE相关（30.2％vs 54.6％; P = .040）。平均随访7.2个月后，CR复发VTE（14.0％vs 6.8％; P = .045）和死亡率（23.5％vs 7.1％; P <.0001）的风险更高。
结论：诱发性DVT伴CR因素会影响老年患者，与诱发性DVT伴TR因素相比具有较高的VTE复发率和死亡率。
