Abstract
BackgroundFew data exist on deep vein thrombosis (DVT) in patients with acute respiratory distress syndrome (ARDS), a group of heterogeneous diseases characterized by acute hypoxemia.Study design and methodsWe retrospectively enrolled 225 adults with ARDS admitted to the Beijing Chao-Yang Hospital and the First Affiliated Hospital of Shandong First Medical University between 1 January 2015 and 30 June 2020. We analyzed clinical, laboratory, and echocardiography data for groups with and without DVT and for direct (pulmonary) and indirect (extrapulmonary) ARDS subgroups.ResultsNinety (40.0%) patients developed DVT. Compared with the non-DVT group, patients with DVT were older, had lower serum creatinine levels, lower partial pressure of arterial oxygen/fraction of inspired oxygen, higher serum procalcitonin levels, higher Padua prediction scores, and higher proportions of sedation and invasive mechanical ventilation (IMV). Multivariate analysis showed an association between age, serum creatinine level, IMV, and DVT in the ARDS cohort. The sensitivity and specificity of corresponding receiver operating characteristic curves were not inferior to those of the Padua prediction score and the Caprini score for screening for DVT in the three ARDS cohorts. Patients with DVT had a significantly lower survival rate than those without DVT in the overall ARDS cohort and in the groups with direct and indirect ARDS.ConclusionsThe prevalence of DVT is high in patients with ARDS. The risk factors for DVT are age, serum creatinine level, and IMV. DVT is associated with decreased survival in patients with ARDS.
Highlights
Deep vein thrombosis (DVT) and pulmonary embolism (PE), collectively referred to as venous thromboembolism (VTE), constitute a major global burden of disease [1]
A total of 225 patients with acute respiratory distress syndrome (ARDS) were enrolled in this study; 111 patients were considered to belong in the direct ARDS group and 114 patients in the indirect ARDS group
The results showed that invasive mechanical ventilation (IMV) was an independent risk factor for deep vein thrombosis (DVT) in both direct and indirect ARDS cohorts
Summary
Deep vein thrombosis (DVT) and pulmonary embolism (PE), collectively referred to as venous thromboembolism (VTE), constitute a major global burden of disease [1]. Patients with acute respiratory distress syndrome (ARDS). Cui et al Thrombosis Journal (2021) 19:71 approach to reducing these heterogeneities is to subclassify patients with ARDS as having direct (pulmonary) or indirect (extrapulmonary) ARDS based on variabilities in the pathological, radiological, and respiratory mechanical responses to different management strategies [12,13,14,15,16,17,18,19]. We performed a multi-institutional study to identify the prevalence, risk factors, and prognosis of DVT and to determine whether the predictors of DVT differed between direct and indirect ARDS in a cohort of patients identified with ARDS. Few data exist on deep vein thrombosis (DVT) in patients with acute respiratory distress syndrome (ARDS), a group of heterogeneous diseases characterized by acute hypoxemia
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