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Assessment of thromboembolism risk in COVID-19 patients with cardiovascular disease risk factors: Analysis of a Japanese Nationwide Registry

発表形態:
原著論文
主要業績:
主要業績
単著・共著:
共著
発表年月:
2022年08月
DOI:
10.1016/j.thromres.2022.06.007
会議属性:
指定なし
査読:
有り
リンク情報:

日本語フィールド

著者:
*Eiji Shibahashi, Kentaro Jujo, Shunsuke Kuroda, Shingo Matsumoto, Takahide Sano, Takeshi Kitai, Taishi Yonetsu, Shun Kohsaka, Sho Torii, Tetsuo Yamaguchi, Takuya Kishi, Issei Komuro, Kenichi Hirata, Koichi Node, Yuya Matsue
題名:
Assessment of thromboembolism risk in COVID-19 patients with cardiovascular disease risk factors: Analysis of a Japanese Nationwide Registry
発表情報:
Thromb Res 巻: 216 ページ: 90-96
キーワード:
Cardiovascular disease risk factors; Coronavirus disease-2019; In-hospital mortality; Prediction model; Thromboembolism
概要:
Introduction: Patients with COVID-19 and cardiovascular disease risk factors (CVDRF) have been reported to develop coagulation abnormalities frequently. However, there are limitations in conventional predictive models for the occurrence of thromboembolism in patients with COVID-19 and CVDRF. Methods: Among data on 1518 hospitalized patients with COVID-19 registered with CLAVIS-COVID, a Japanese nationwide cohort study, 693 patients with CVDRF were subjected to least absolute shrinkage and selection operator (LASSO) analysis; a method of shrinking coefficients for reducing variance and minimizing bias to increase predictive accuracy. LASSO analysis was performed to identify risk factors for systemic thromboembolic events; occurrence of arterial and venous thromboembolism during the index hospitalization as the primary endpoint. Results: LASSO analysis identified a prior systemic thromboembolism, male sex, hypoxygenemia requiring invasive mechanical ventilation support, C-reactive protein levels and D-dimer levels at admission, and congestion on chest X-ray at admission as potential risk factors for the primary endpoint. The developed risk model consisting of these risk factors showed good discriminative performance (AUC-ROC: 0.83, 95 % confidence interval [CI]: 0.77-0.90), which was significantly better than that shown by D-dimer (AUC-ROC: 0.70, 95 % CI: 0.60-0.80) (p < 0.001). Furthermore, systemic embolic events were independently associated with in-hospital mortality (adjusted odds ratio: 3.29; 95 % CI: 1.31-8.00). Conclusions: Six parameters readily available at the time of admission were identified as risk factors for thromboembolic events, and these may be capable of stratifying the risk of in-hospital thromboembolic events, which are associated with in-hospital mortality, in patients with COVID-19 and CVDRF.
抄録:

英語フィールド

Author:
*Eiji Shibahashi, Kentaro Jujo, Shunsuke Kuroda, Shingo Matsumoto, Takahide Sano, Takeshi Kitai, Taishi Yonetsu, Shun Kohsaka, Sho Torii, Tetsuo Yamaguchi, Takuya Kishi, Issei Komuro, Kenichi Hirata, Koichi Node, Yuya Matsue
Title:
Assessment of thromboembolism risk in COVID-19 patients with cardiovascular disease risk factors: Analysis of a Japanese Nationwide Registry
Announcement information:
Thromb Res Vol: 216 Page: 90-96
Keyword:
Cardiovascular disease risk factors; Coronavirus disease-2019; In-hospital mortality; Prediction model; Thromboembolism
An abstract:
Introduction: Patients with COVID-19 and cardiovascular disease risk factors (CVDRF) have been reported to develop coagulation abnormalities frequently. However, there are limitations in conventional predictive models for the occurrence of thromboembolism in patients with COVID-19 and CVDRF. Methods: Among data on 1518 hospitalized patients with COVID-19 registered with CLAVIS-COVID, a Japanese nationwide cohort study, 693 patients with CVDRF were subjected to least absolute shrinkage and selection operator (LASSO) analysis; a method of shrinking coefficients for reducing variance and minimizing bias to increase predictive accuracy. LASSO analysis was performed to identify risk factors for systemic thromboembolic events; occurrence of arterial and venous thromboembolism during the index hospitalization as the primary endpoint. Results: LASSO analysis identified a prior systemic thromboembolism, male sex, hypoxygenemia requiring invasive mechanical ventilation support, C-reactive protein levels and D-dimer levels at admission, and congestion on chest X-ray at admission as potential risk factors for the primary endpoint. The developed risk model consisting of these risk factors showed good discriminative performance (AUC-ROC: 0.83, 95 % confidence interval [CI]: 0.77-0.90), which was significantly better than that shown by D-dimer (AUC-ROC: 0.70, 95 % CI: 0.60-0.80) (p < 0.001). Furthermore, systemic embolic events were independently associated with in-hospital mortality (adjusted odds ratio: 3.29; 95 % CI: 1.31-8.00). Conclusions: Six parameters readily available at the time of admission were identified as risk factors for thromboembolic events, and these may be capable of stratifying the risk of in-hospital thromboembolic events, which are associated with in-hospital mortality, in patients with COVID-19 and CVDRF.


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