Open AccessVenous thromboembolism in critically ill patients with pneumonia in the pre‐COVID ‐19 era: Data from a large public database
Author(s) -
Pisani Miguel,
Orsi Fernanda A.,
AnnichinoBizzacchi Joyce M.,
Barco Stefano,
De Paula Erich V.
Publication year - 2022
Publication title -
research and practice in thrombosis and haemostasis
Language(s) - English
Resource type - Journals
ISSN - 2475-0379
DOI - 10.1002/rth2.12816
Subject(s) - medicine , pneumonia , intensive care unit , incidence (geometry) , intensive care medicine , venous thromboembolism , cumulative incidence , intensive care , cohort study , cohort , emergency medicine , thrombosis , physics , optics
Background The magnitude of venous thromboembolism (VTE) risk in severe COVID‐19 is a matter of debate because of study heterogeneity, changes in VTE management, and scarce evidence of VTE risk in critically ill patients with pneumonia in the pre‐COVID‐19 era. Objectives To evaluate VTE risk in the pre‐COVID‐19 era in a large intensive care unit (ICU) database. Patients/Methods Data from consecutive pneumonia patients admitted to the ICU were retrieved from the Medical Information Mart for Intensive Care III . VTE risk was described in the entire cohort and in subgroups. Results Among 6842 pneumonia patients admitted to the ICU, 486 patients were diagnosed with VTE after a median of 3 (IQR 1–11) days in the ICU. The 30‐day cumulative incidence of VTE was 7% and remained at this level across different age groups, sex, and type of ICU. After adjusting for death, the overall cumulative incidence of VTE was 5%. A total of 1788 patients received thromboprophylaxis (of 2958 for whom that data were available). VTE occurred in 10.7% (95% CI 9.0–12.6) of patients without thromboprophylaxis and in 6.4% (95% CI 5.4–7.6) of those with thromboprophylaxis. Mortality was 20.6% among patients with VTE and 19.2% among those without VTE. Conclusions In the pre‐COVID‐19 era, VTE risk in ICU patients with pneumonia was high and decreased with thromboprophylaxis. These findings can serve as comparators for future studies aiming at evaluating the impact of COVID‐19 or other emerging infections on VTE risk.