2 型糖尿病患者和非 2 型糖尿病患者结直肠癌手术后出血和静脉血栓栓塞风险:丹麦队列研究

TH open : companion journal to thrombosis and haemostasis Pub Date : 2024-03-26 eCollection Date: 2024-01-01 DOI:10.1055/a-2275-9590
Frederik Pagh Bredahl Kristensen, Erzsébet Horváth-Puhó, Szimonetta Komjáthiné Szépligeti, Frederikke Schoenfeldt Troelsen, Henrik Toft Sørensen
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引用次数: 0

摘要

背景出血和静脉血栓栓塞(VTE)是结直肠癌(CRC)手术后的不良后果。2 型糖尿病(T2D)与出血和 VTE 风险因素相关。我们研究了接受 CRC 手术的 T2D 患者的出血和 VTE 风险以及出现这些不良后果后的预后。方法 我们开展了一项基于人群的预后队列研究,研究对象是 2005 年至 2019 年期间因偶发 CRC 而接受手术治疗的 48,295 名 T2D 患者和非 T2D 患者。患有 T2D 的患者是在医院环境中确诊的,或者已经兑换了降糖药物处方;其余的队列是没有糖尿病的患者。我们估算了出血和 VTE 的 30 天和 1 年风险,并使用 Fine-Gray 模型计算了经年龄、性别和日历年调整的亚分布危险比 (SHR)。采用 Kaplan-Meier 法计算出血或 VTE 后的 1 年死亡率。结果 在 CRC 手术后 30 天内,T2D 患者的出血风险为 2.7%,非糖尿病患者的出血风险为 2.0%(SHR:1.30 [95% 置信区间 [CI]:1.10-1.53])。对于 VTE,T2D 患者的 30 天风险为 0.6%,非糖尿病患者为 0.6%(SHR:1.01 [95% CI:0.71-1.42])。CRC手术后1年内出血和VTE的SHR值相似。在出血队列中,T2D 患者的 1 年死亡率为 26.0%,而非糖尿病患者为 24.9%;在 VTE 队列中,T2D 患者的 1 年死亡率为 25.8%,而非糖尿病患者为 27.5%。结论 虽然绝对风险较低,但 T2D 患者在 CRC 手术后出血的风险会增加,而 VTE 的风险不会增加。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Risk of Bleeding and Venous Thromboembolism after Colorectal Cancer Surgery in Patients with and without Type 2 Diabetes: A Danish Cohort Study.

Background  Bleeding and venous thromboembolism (VTE) are adverse outcomes after colorectal cancer (CRC) surgery. Type 2 diabetes (T2D) clusters with bleeding and VTE risk factors. We examined the bleeding and VTE risk in patients with T2D undergoing CRC surgery and the prognosis after these adverse outcomes. Methods  We conducted a prognostic population-based cohort study of 48,295 patients with and without T2D undergoing surgery for incident CRC during 2005 to 2019. Patients with T2D were diagnosed in a hospital setting or had redeemed a glucose-lowering drug prescription; the remaining cohort was patients without diabetes. We estimated the 30-day and 1-year risks of bleeding and VTE and used a Fine-Gray model to compute age-, sex-, and calendar year-adjusted subdistribution hazard ratios (SHRs). The Kaplan-Meier method was used to calculate 1-year mortality after bleeding or VTE. Results  Within 30 days after CRC surgery, the risk of bleeding was 2.7% in patients with T2D and 2.0% in patients without diabetes (SHR: 1.30 [95% confidence interval [CI]: 1.10-1.53]). For VTE, the 30-day risks were 0.6% for patients with T2D and 0.6% for patients without diabetes (SHR: 1.01 [95% CI: 0.71-1.42]). The SHRs for bleeding and VTE within 1 year after CRC surgery were similar. The 1-year mortality was 26.0% versus 24.9% in the bleeding cohort and 25.8% versus 27.5% in the VTE cohort for patients with T2D versus without diabetes, respectively. Conclusion  Although absolute risks were low, patients with T2D have an increased risk of bleeding but not VTE after CRC surgery.

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