Risk Factors Of Venous Thromboembolism Recurrence And The Predictive Value Of Risk Assessment For Recurrence In Plateau Area

Objective: Recurrent venous thromboembolism is a risk event that seriously endangers the prognosis and quality of life of patients with venous thromboembolism.The aim of this study is to explore the risk factors of recurrent venous thromboembolism by analyzing the clinical data and risk stratification of patients with initial diagnosis of pulmonary thromboembolism,in order to identify high-risk patients with recurrent venous thromboembolism in plateau area as soon as possible,and to provide plateau data for early intervention.Methods: This study was a retrospective cohort study.Clinical data of 398 patients with initially diagnosed VTE in Tibet Autonomous Region People’s Hospital from January 2019 to December 2020 were collected.According to the inclusion and exclusion criteria and whether the patients had recurrent VTE events,they were divided into recurrent group and non-recurrent group.The differences in gender,comorbidities/risk factors,laboratory examination and ultrasound examination data between the two groups were analyzed.Difference test analysis and survival analysis were used to determine the risk factors and hazard ratio of recurrent venous thromboembolism.Results: A total of 320 patients were included in the final analysis,of whom 31patients(9.7%)had VTE recurrence within two years after initial diagnosis,with a median recurrence time of 9.0(5.0,15.0).The analysis of patients between the recurrence group and the non-recurrence group showed that there was no significant difference in gender,age,underlying disease,embolism site,and type of anticoagulant drugs between the two groups.Univariate analysis showed that survival analysis was significant between uncaused VTE,ESC risk stratification,CCI,and anticoagulant therapy time.Multivariate analysis only ESC stratification was not significant.Finally,the HR of secondary VTE recurrence was 0.359(0.165-0.782)compared with uninitiated VTE,and the HR of VTE recurrence in patients with prolonged anticoagulation therapy was 0.422(0.202-0.884)compared with patients without prolonged anticoagulation therapy.But CCI every increase 1 minute,recurrence of VTE risk by a factor of 1.387(0.663 2.904).Conclusions: Unprovoked VTE increases the risk of VTE recurrence,while prolonged anticoagulation therapy can reduce the risk of VTE recurrence.The prediction of VTE risk assessment on the risk of VTE recurrence needs further verification,and CCI may be one of the tools to evaluate the risk of VTE recurrence.