肺栓塞患者囊性纤维化及其对预后的影响

IF 3.4 3区医学 Q1 HEMATOLOGY

Thrombosis research Pub Date : 2025-09-21 DOI:10.1016/j.thromres.2025.109499

Karsten Keller , Volker H. Schmitt , Visvakanth Sivanathan , Omar Hahad , Thomas Münzel , Philipp Lurz , Christine Espinola-Klein , Stefano Barco , Stavros Konstantinides , Lukas Hobohm

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引用次数: 0

摘要

肺栓塞（PE）和囊性纤维化（CF）都是影响心血管-肺系统的疾病。CF是一种罕见的异源单基因常染色体隐性遗传性多系统疾病，可降低预期寿命，而PE是一种常见的紧急事件，发病率和死亡率也很高。我们旨在探讨CF对PE患者预后的影响。方法采用德国全国住院患者样本进行研究。我们纳入了2005-2020年德国所有PE患者，并对其进行了cf分层。结果2005-2020年，我们共纳入了1373084例PE患者（中位年龄72.0岁，53.0%为女性）。其中126例（0.01%）被编码为CF。CF的PE患者较年轻（33.0[24.0-43.0]比72.0[60.0-80.0]岁，P < 0.001），动脉高血压、高脂血症的患病率较低，合并症负担较低（Charlson合并症指数：2.0[1.0-4.0]比4.0 [3.0-7.0],P < 0.001）。相比之下，CF的PE患者糖尿病发生率更高（49.2%比18.7%,P < 0.001）。在调整了年龄、性别和合并症后，CF与较高的病死率（OR 2.451 [95% CI 1.542-3.896], P < 0.001）、肺炎（OR 1.518 [95% CI 1.059-2.176], P = 0.023）和输血必要性（OR 3.702 [95% CI 2.540-5.396], P < 0.001）相关。结论spe合并CF患者在PE事件发生时较未合并CF的PE患者更年轻，并伴有糖尿病、肾脏疾病等典型合并症。CF的并发症发生率更高，包括肺炎、出血事件，病死率增加2.5倍。

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Cystic fibrosis and its impact on prognosis in pulmonary embolism

Background

Pulmonary embolism (PE) and cystic fibrosis (CF) are both diseases that impact the cardiovascular-pulmonary system. While CF is a rare heterogeneous monogenetic autosomal-recessive inherited multisystem-disease that reduces life-expectancy, PE is a common emergency event with also high morbidity and mortality. We aimed to investigate the impact of CF on prognosis of PE patients.

Methods

The German nationwide inpatient sample was used for this study. All patient-cases of patients with PE in Germany 2005–2020 were included and stratified for CF.

Results

Overall, 1,373,084 patient-cases of PE patients (median age 72.0 years, 53.0 % females) in Germany were included in our study 2005–2020. Among these, 126 patients (0.01 %) were coded with CF.

PE patients with CF were younger (33.0 [24.0–43.0] vs. 72.0 [60.0–80.0] years, P < 0.001) displaying a lower prevalence of arterial hypertension, hyperlipidemia and lower comorbidity-burden (Charlson comorbidity index: 2.0 [1.0–4.0] vs. 4.0 [3.0–7.0], P < 0.001) compared to those without CF. In contrast, diabetes mellitus was more frequent in PE patients with CF (49.2 % vs. 18.7 %, P < 0.001).

After adjustment for age, sex and comorbidities, CF was associated with higher case-fatality (OR 2.451 [95 % CI 1.542–3.896], P < 0.001), pneumonia (OR 1.518 [95 % CI 1.059–2.176], P = 0.023) and necessity regarding transfusion of blood constituents (OR 3.702 [95 % CI 2.540–5.396], P < 0.001).

Conclusions

PE patients with CF were younger at the time of PE event and accompanied by typical comorbidities such as diabetes mellitus and renal disease compared to PE patients without CF. CF was associated with higher complication rates comprising pneumonia, bleeding events and 2.5-fold increased case-fatality.

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来源期刊

Thrombosis research 医学-外周血管病

CiteScore

14.60

自引率

4.00%

发文量

364

审稿时长

31 days

期刊介绍： Thrombosis Research is an international journal dedicated to the swift dissemination of new information on thrombosis, hemostasis, and vascular biology, aimed at advancing both science and clinical care. The journal publishes peer-reviewed original research, reviews, editorials, opinions, and critiques, covering both basic and clinical studies. Priority is given to research that promises novel approaches in the diagnosis, therapy, prognosis, and prevention of thrombotic and hemorrhagic diseases.