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Table 4 Effect of preventive heparin on PE diagnosis and in-hospital death by multi-state transition model

From: Effect of heparin treatment on pulmonary embolism and in-hospital death in unvaccinated COVID-19 patients without overt deep vein thrombosis

Variable

Patients who started heparin after PE diagnosis reclassified as not treated (n=401)

Patients who started heparin after PE diagnosis are excluded from the analysis (n=342)

 

HR (95% CI)

p

HR (95% CI)

p

Transition 1 (COVID-19 Dx → PE)

 Age (each year)

1.00 (0.98–1.01)

0.600

0.99 (0.97–1.02)

0.659

 BMI (each 1 kg/m2)

1.00 (0.97–1.03)

0.992

1.00 (0.96–1.04)

0.928

 COVID-19 severity (each)

1.56 (1.21–2.01)

 < 0.001

1.43 (1.00–2.04)

0.050

 Active neoplasia (no/yes)

0.83 (0.48–1.45)

0.513

0.77 (0.35–1.71)

0.523

 COPD (no/yes)

0.50 (0.20–1.25)

0.140

0.39 (0.09–1.63)

0.195

 D-dimer (log ng/dl FEU)

1.34 (1.17–1.54)

 < 0.001

1.40 (1.17–1.68)

 < 0.001

Preventive heparin use:

 • No (Ref.)

1

-

1

-

 • Prophylactic dose

0.13 (0.07–0.22)

 < 0.001

0.29 (0.14–0.63)

0.002

 • Intermediate/therapeutic dose

0.18 (0.11–0.28)

 < 0.001

0.41 (0.19–0.86)

0.018

Transition 2 (COVID-19 Dx → DEATH)

 Age (each year)

1.08 (1.05–1.12)

 < 0.001

1.07 (1.04–1.11)

 < 0.001

 BMI (each 1 kg/m2)

0.94 (0.89–1.00)

0.062

0.94 (0.89–1.00)

0.068

 COVID-19 severity (each 1 class)

3.20 (2.08–4.92)

 < 0.001

3.31 (2.16–5.06)

 < 0.001

 Active neoplasia (no/yes)

2.66 (1.35–5.24)

0.005

2.55 (1.30–5.02)

0.007

 COPD (no/yes)

1.98 (0.87–4.50)

0.101

1.73 (0.76–3.95)

0.193

 D-dimer (log ng/dl FEU)

0.86 (0.69–1.08)

0.196

0.88 (0.71–1.11)

0.284

Preventive heparin use:

 • No (Ref.)

1

-

1

-

 • Prophylactic dose

0.43 (0.20–0.92)

0.029

0.31 (0.14–0.68)

0.003

 • Intermediate/therapeutic dose

0.44 (0.19–0.97)

0.042

0.30 (0.13–0.71)

0.006

Transition 3 (PE → DEATH)

 Age (each year)

1.01 (0.97–1.05)

0.644

1.01 (0.96–1.05)

0.721

 BMI (each 1 kg/m2)

0.99 (0.94–1.04)

0.649

0.99 (0.94–1.05)

0.822

 COVID-19 severity (each 1 class)

3.74 (1.59–8.80)

0.002

3.28 (1.21–8.91)

0.019

 Active neoplasia (no/yes)

3.92 (1.45–10.5)

0.007

3.80 (0.89–16.3)

0.072

 COPD (no/yes)

0.73 (0.14–3.79)

0.712

0.85 (0.12–6.05)

0.870

 D-dimer (log ng/dl FEU)

1.03 (0.76–1.39)

0.856

0.98 (0.67–1.44)

0.932

Preventive heparin use:

 • No (Ref.)

1

-

1

-

 • Prophylactic dose

1.37 (0.49–3.83)

0.549

1.16 (0.23–7.89)

0.857

 • Intermediate/therapeutic dose

1.43 (0.53–3.85)

0.474

1.12 (0.22–5.72)

0.893

Effect of PE diagnosis and time to PE diagnosis on in-hospital death

 PE diagnosis (no/yes)

2.3 (0.00–1003)

0.792

2.2 (0.00–2006)

0.822

 Time to PE diagnosis (each day)

1.06 (0.99–1.13)

0.086

1.07 (0.98–1.17)

0.113

  1. HR Hazards ratio, PE Pulmonary embolism WHO World Health Organization, BMI Body mass index, COPD Chronic obstructive pulmonary disease, Ref. Reference, FEU Fibrinogen equivalent units
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Thrombosis Journal

ISSN: 1477-9560

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