神经重症患者静脉血栓栓塞的发生率、危险因素及住院结局分析

目的 探讨神经重症患者静脉血栓栓塞（venous thromboembolism，VTE）的发生率，并分析VTE相关 的危险因素及其对住院结局的影响。 方法 基于电子病历系统数据回顾性分析2019年10月-2020年9月首都医科大学附属北京天坛医院 的神经重症患者，根据患者住ICU期间是否发生VTE分为VTE组和无VTE组，计算VTE的发生率，通过多 因素logistic回归分析神经重症患者VTE的危险因素，并比较两组间死亡率、住ICU时间、住院时间及住 院费用的差异。 结果 共纳入神经重症患者723例，年龄中位数52岁，男性383例（53.0%），其中330例（45.6%）患 者发生VTE。多因素logistic回归分析结果显示，年龄（OR 1.078，95%CI 1.053～1.104）、BM（I OR 1.082， 95%CI 1.013～1.156）和D-二聚体水平（OR 1.042，95%CI 1.006～1.079）升高是发生VTE的独立危险 因素。两组死亡率无统计学差异（4.8% vs 3.6%，P =0.388），VTE组住院天数（21 d vs 18 d）、住I CU天数 （8 d vs 5 d）及住院费用（121 358元 vs 93 717元）较无VTE组增加（均P＜0.001）。 结论 神经重症患者VTE的发生率为45.6%，年龄、BMI和D-二聚体水平升高是其独立危险因素。发 生VTE可延长患者住院时间、住ICU时间，增加患者住院费用。

Incidence,Risk Factors and In-hospital Outcome of Venous Thromboembolism in Neurocritical Patients

Objective To explore the incidence and risk factors of venous thromboembolism (VTE) in neurocritical patients, and the influence of VTE on in-hospital outcomes. Methods The data of the neurocritical patients in Beijing Tiantan Hospital from October 2019 to September 2020 were retrospectively analyzed. According to the presence of VTE or not after SAH during ICU hospitalization, the patients were divided into VTE group and non-VTE group. The incidence of VTE was calculated. The differences in mortality, the length of ICU stay and hospital stay, and the cost of hospitalization were compared between the two groups. Multivariate logistic regression analysis was used to identify the risk factors of VTE in neurocritical patients. Results A total of 723 patients were included in this study, with a median age of 52 years old and 383 males (53.0%), and 330 patients (45.6%) had VTE. Multivariate logistic regression analysis showed that the age (OR 1.078, 95%CI 1.053-1.104), BMI (OR 1.082, 95%CI 1.013-1.156), and D-dimer level (OR 1.042, 95%CI 1.006-1.079) were independent risk factors for VTE. The inhospital mortality between the two groups had no statistical difference (4.8% vs 3.6%, P =0.388). However, compared with non-VTE group, the length of hospital stay (21 d vs 18 d), the length ofICU stay (8 d vs 5 d) and the cost of hospitalization (121 358 CNY vs 93 717 CNY) increased in