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Lippi G, Mattiuzzi C, Favaloro EJ. Recent monthly mortality for pulmonary embolism in the US. Thromb Res 2024; 233:99-100. [PMID: 38035648 DOI: 10.1016/j.thromres.2023.11.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 11/23/2023] [Accepted: 11/24/2023] [Indexed: 12/02/2023]
Affiliation(s)
- Giuseppe Lippi
- Section of Clinical Biochemistry, School of Medicine, University of Verona, Verona, Italy.
| | - Camilla Mattiuzzi
- Medical Direction, Rovereto Hospital, Service of Clinical Governance and Medical Direction, Provincial Agency for Social and Sanitary Services (APSS), Trento, Italy
| | - Emmanuel J Favaloro
- Department of Haematology, Institute of Clinical Pathology and Medical Research (ICPMR), Sydney Centres for Thrombosis and Haemostasis, NSW Health Pathology, Westmead Hospital, Westmead, NSW, Australia; School of Dentistry and Medical Sciences, Faculty of Science and Health, Charles Sturt University, Wagga Wagga, New South Wales, Australia; School of Medical Sciences, Faculty of Medicine and Health, University of Sydney, Westmead Hospital, Westmead, New South Wales, Australia
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Thomas SA, Wang G, Giordano N, Matthews T, Torrey J, Kabrhel C. Calendar month variation in the diagnosis and severity of pulmonary embolism. Intern Emerg Med 2023; 18:879-887. [PMID: 36656430 DOI: 10.1007/s11739-022-03180-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 12/13/2022] [Indexed: 01/20/2023]
Abstract
BACKGROUND Pulmonary embolism (PE) is the third-leading cause of cardiovascular death in the United States, and several studies suggest PE shows seasonal variation. Variation in monthly PE diagnosis may be due to pathophysiologic factors or confounding/bias. However, severe PE may be less prone to diagnostic bias. To address this gap, we analyzed two registries from 1/2013-12/2018 with the aim of describing temporal trends in PE diagnosis and severity. METHODS We performed a retrospective analysis of two existing databases containing: (1) consecutive patients diagnosed with PE in the emergency departments (EDs) of two large, urban teaching hospitals, and (2) severe PEs requiring PE Response Team (PERT) activation at one of the above hospitals. The primary outcome was to assess variation in PE diagnosis and severity by calendar month. Separate analysis of these two databases sought to control for workup bias by trainee experience across the academic year. One-way ANOVA and Poisson regression were performed to assess for cyclical variation across calendar months, using Stata v16.1. RESULTS The PE diagnosis database contained 1324 patients over 36 months. One-way ANOVA did not reveal a statistically significant (p = 0.713) association between calendar month and PE number. The PERT activation database contained 1082 patients over 72 months. One-way ANOVA revealed a statistically significant (p = 0.024) association between calendar month and activations, repeated year-on-year. CONCLUSION Our results indicate correlation between calendar month and PERT activation; however, this pattern was not observed for PE diagnoses. This finding warrants further investigation into the causes of calendar month variation of PERT activations.
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Affiliation(s)
- Sarah Alice Thomas
- Faculty of Medicine, BSc Medical Biosciences Candidate, Imperial College London, London, UK
- Department of Emergency Medicine, Center for Vascular Emergencies, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Grace Wang
- Department of Emergency Medicine, Center for Vascular Emergencies, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Nicholas Giordano
- Department of Emergency Medicine, Center for Vascular Emergencies, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Tim Matthews
- Department of Emergency Medicine, Center for Vascular Emergencies, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Jasmine Torrey
- Institute of Health Professionals, Massachusetts General Hospital, Zero Emerson Place, Suite 3B, Boston, MA, USA
| | - Christopher Kabrhel
- Department of Emergency Medicine, Center for Vascular Emergencies, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
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Barp M, Carneiro VSM, Malaquias SG, Pagotto V. Temporal trend in venous thromboembolism hospitalization rates in Brazilian older adults, 2010-2020. J Thromb Thrombolysis 2023; 55:156-165. [PMID: 36335519 DOI: 10.1007/s11239-022-02724-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/19/2022] [Indexed: 11/08/2022]
Abstract
Aging is one of the main risk factors for venous thromboembolism (VTE). Changes in prevention, diagnosis, and treatment strategies for this condition in recent years require an analysis of its rates in health services. The objective of this study was to analyze a temporal trend of hospitalizations for VTE in Brazilian older adults. This ecological time series study used data from the Hospital Information System (HIS) on VTE hospitalizations from 2010 to 2020, selecting admissions with the main diagnosis of pulmonary thromboembolism (PTE) (I.26.0, I.26.9) and deep vein thrombosis (DVT) (I.80.0, I80.1, I80.2, I80.3, I80.8, I80.9). Hospitalization rates were calculated for each year and the Prais-Winsten. In Brazil, the trend of hospitalizations for VTE decreased, with an annual percentage change of - 40.71 (confidence interval [CI] - 50.46; - 29.04). DVT decreased, with an annual percentage change of - 43.14 (95% confidence interval [CI] - 51.36; - 33.54). All Brazilian regions showed a downward trend in hospitalizations for VTE and DVT, except for the Northeast region, which remained stable. Conversely, the trend of hospitalizations for PTE showed an upward in Brazil, with an annual percentage change of 4.33 (95% CI 1.26; 7.48). An upward trend was observed in hospitalizations for PTE in the Northeast region, and a stationary trend was observed in the other regions. The results showed a downward trend in hospitalization rates for DVT and an upward trend for PTE. The study indicates regional differences in rates and trends.
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Affiliation(s)
- Milara Barp
- Graduate Program in Nursing, Faculty of Nursing, Federal University of Goiás, Goiânia, Goiás, Brazil.
| | | | | | - Valéria Pagotto
- Faculty of Nursing, Federal University of Goiás, Goiânia, Goiás, Brazil
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Liu X, Xu A, Huang J, Shen H, Liu Y. Effective prediction model for preventing postoperative deep vein thrombosis during bladder cancer treatment. J Int Med Res 2022; 50:3000605211067688. [PMID: 34986677 PMCID: PMC8753248 DOI: 10.1177/03000605211067688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Objective To begin to understand how to prevent deep vein thrombosis (DVT) after an innovative operation termed intracorporeal laparoscopic reconstruction of detenial sigmoid neobladder, we explored the factors that influence DVT following surgery, with the aim of constructing a model for predicting DVT occurrence. Methods This retrospective study included 151 bladder cancer patients who underwent intracorporeal laparoscopic reconstruction of detenial sigmoid neobladder. Data describing general clinical characteristics and other common parameters were collected and analyzed. Thereafter, we generated model evaluation curves and finally cross-validated their extrapolations. Results Age and body mass index were risk factors for DVT, whereas postoperative use of hemostatic agents and postoperative passive muscle massage were significant protective factors. Model evaluation curves showed that the model had high accuracy and little bias. Cross-validation affirmed the accuracy of our model. Conclusion The prediction model constructed herein was highly accurate and had little bias; thus, it can be used to predict the likelihood of developing DVT after surgery.
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Affiliation(s)
- Xing Liu
- Department of Urology, 36613Zhujiang Hospital, Zhujiang Hospital, 70570Southern Medical University, Guangzhou, China
| | - Abai Xu
- Department of Urology, 36613Zhujiang Hospital, Zhujiang Hospital, 70570Southern Medical University, Guangzhou, China
| | - Jingwen Huang
- Department of Urology, 36613Zhujiang Hospital, Zhujiang Hospital, 70570Southern Medical University, Guangzhou, China
| | - Haiyan Shen
- Department of Urology, 36613Zhujiang Hospital, Zhujiang Hospital, 70570Southern Medical University, Guangzhou, China
| | - Yazhen Liu
- Department of Urology, 36613Zhujiang Hospital, Zhujiang Hospital, 70570Southern Medical University, Guangzhou, China
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Signorelli SS, Oliveri Conti G, Carpinteri G, Lumera G, Fiore M, Dattilo G, Gaudio A, Ferrante M. Venous thromboembolism in hospital emergency room. A retrospective study on climatic effect. ENVIRONMENTAL RESEARCH 2021; 197:110950. [PMID: 33737078 DOI: 10.1016/j.envres.2021.110950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 02/25/2021] [Accepted: 02/25/2021] [Indexed: 06/12/2023]
Abstract
Several cardiovascular conditions exhibit seasonality in frequency and mortality, but little is known about the seasonality of Venous ThromboEmbolism (VTE), a very relevant medical condition, and seasonal influences are still conflicting. Patients having co-morbidities, individual suffered from dyspnea, swelling, edema of lower limb, pain (chest, lower limbs) are admitted frequently to the hospital emergency room (HER), particularly. Both mark a potential risk for VTE, that can be increased also by seasonality. A four years retrospective analysis (2016-2019) was carried out in individuals and patients admitted to the HER of the Hospital of Catania (a Mediterranean city of Sicily, Italy) to evaluate the VTE frequency and its seasonal differences, common symptoms, potential usage of some common laboratory tests. Dyspnea, swelling, edema of lower limb and pain (chest, lower limbs) were considered to suspect pulmonary embolism (PE) or for deep vein thrombosis of lower limb (DVT). Platelet count, platelet volume, fibrinogen, C-reactive protein, and D-dimer were considered. VTE frequency per year was 2.9/10,000 (2016), 4.9/10,000 (2017) 3.6/10,000 (2018), and 5.1/10,000 (2019) respectively. Dyspnea was highly frequent for PE, edema and lower limb pain were frequent in DVT patients. Fibrinogen, C reactive protein, and D-dimer values were found raised in all the VTE patients. Platelet volume was found higher in DVT than PE VTE events that occurred in warm periods were modestly greater (57 VTE: 38 DVT, 19 PE) compared to cold months (52 VTE: 34 DVT, 18 PE). Our results could be explained by the increased sweating due to the high temperatures, which in turn, can affect both on plasma concentration and on hematocrit value coupled to the reduction in atmospheric pressure determining both a hyper-coagulative condition. Climate seasonal characteristics, and environmental conditions in Catania city (Sicily) may be as reasonable items in expecting on different VTE rates in warm period compared to cold. This study highlights no specific symptoms, and confirms the common lab tests for individuals and patients admitted to HER as simple and helpful tools in initiating none or mini-invasive diagnostic strategy for the VTE. Finally, the climate/seasonality coupled with latitude can have a direct influence on the incidence of DVT.
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Affiliation(s)
- Salvatore Santo Signorelli
- Department of Clinical and Experimental Medicine. University of Catania, Italy; Internal Medicine Unit. University Hospital "G. Rodolico", Catania, Italy.
| | - Gea Oliveri Conti
- Department of Medical, Surgical Sciences and Advanced Technologies "G.F. Ingrassia". University of Catania, Italy.
| | - Giuseppe Carpinteri
- Emergengy Medicine Division. University Hospital "G. Rodolico", Catania, Italy
| | - Giovanni Lumera
- Department of Clinical and Experimental Medicine. University of Catania, Italy; Internal Medicine Unit. University Hospital "G. Rodolico", Catania, Italy
| | - Maria Fiore
- Department of Medical, Surgical Sciences and Advanced Technologies "G.F. Ingrassia". University of Catania, Italy
| | - Giuseppe Dattilo
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Agostino Gaudio
- Department of Clinical and Experimental Medicine. University of Catania, Italy
| | - Margherita Ferrante
- Department of Medical, Surgical Sciences and Advanced Technologies "G.F. Ingrassia". University of Catania, Italy
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