TY - JOUR AU - Rosario, Bedda AU - Zhang, Andrew AU - Patel, Mehool AU - Rajmane, Amol AU - Xie, Ning AU - Weeraratne, Dilhan AU - Alterovitz, Gil PY - 2022 DA - 2022/10/21 TI -基于异质患者数据的COVID-19血栓形成并发症危险因素分析:回顾性观察研究JO - J Med Internet Res SP - e35860 VL - 24is - 10kw - COVID-19 KW -血栓性并发症KW - logistic回归KW - EHR KW -电子健康记录KW -保险理赔数据AB -背景:已观察到COVID-19与静脉和动脉血栓形成有关。炎症性疾病延长住院时间，既往存在的合并症可加重COVID-19患者的血栓形成负担。然而，静脉血栓栓塞、动脉血栓形成和其他血管并发症可能在重症监护环境中被忽视。在COVID-19患者群体中，早期风险分层对于主动监测血栓性并发症至关重要。目的:本探索性研究的目的是利用电子健康记录(EHR)和保险索赔数据库的信息，表征与COVID-19相关的血栓性并发症危险因素。目标是开发一种使用真实世界数据证据进行分析的方法，该方法可以推广到其他临床环境中，例如COVID-19患者或重症监护病房的肺炎或急性呼吸窘迫综合征，以表征血栓性并发症和其他条件。方法:我们从保险理赔数据库IBM MarketScan中提取未识别的患者数据，并利用logistic回归方法就患者人口统计学和临床因素对COVID-19患者血栓性并发症提出假设。然后，通过分析研究患者数据登记处(RPDR) Mass General Brigham (MGB)患者EHR数据库中未识别的患者数据，验证了这些假设。根据优势比、95% ci和P值对数据进行分析。 Results: The analysis identified significant predictors (P<.001) for thrombotic complications in 184,831 COVID-19 patients out of the millions of records from IBM MarketScan and the MGB RPDR. With respect to age groups, patients 60 years and older had higher odds (4.866 in MarketScan and 6.357 in RPDR) to have thrombotic complications than those under 60 years old. In terms of gender, men were more likely (odds ratio of 1.245 in MarketScan and 1.693 in RPDR) to have thrombotic complications than women. Among the preexisting comorbidities, patients with heart disease, cerebrovascular diseases, hypertension, and personal history of thrombosis all had significantly higher odds of developing a thrombotic complication. Cancer and obesity were also associated with odds>1. The results from RPDR validated the IBM MarketScan findings, as they were largely consistent and afford mutual enrichment. Conclusions: The analysis approach adopted in this study can work across heterogeneous databases from diverse organizations and thus facilitates collaboration. Searching through millions of patient records, the analysis helped to identify factors influencing a phenotype. Use of thrombotic complications in COVID-19 patients represents only a case study; however, the same design can be used across other disease areas by extracting corresponding disease-specific patient data from available databases. SN - 1438-8871 UR - //www.mybigtv.com/2022/10/e35860 UR - https://doi.org/10.2196/35860 UR - http://www.ncbi.nlm.nih.gov/pubmed/36044652 DO - 10.2196/35860 ID - info:doi/10.2196/35860 ER -