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Risk factors for deep vein thrombosis and pulmonary embolism: a population-based case-control study
J A Heit1, M D Silverstein, D N Mohr
1Division of Cardiovascular Diseases, Mayo Clinic and Mayo Foundation, Rochester, Minn 55905, USA. heit.john@mayo.edu
Archives of Internal Medicine
|March 29, 2000
Summary
Surgery, trauma, and hospitalization are significant risk factors for venous thromboembolism (VTE). Other key factors include cancer, chemotherapy, and neurological disease, highlighting the importance of identifying and managing these risks.
Area of Science:
- Medical research
- Epidemiology
- Vascular medicine
Background:
- Reported risk factors for venous thromboembolism (VTE) show wide variability.
- The precise magnitude and independence of these risk factors remain uncertain.
Purpose of the Study:
- To identify independent risk factors for deep vein thrombosis and pulmonary embolism.
- To quantify the magnitude of risk associated with each identified factor.
Main Methods:
- Population-based, nested case-control study.
- 625 patients with first-time VTE and 625 matched controls from Olmsted County, Minnesota (1976-1990).
- Matching criteria included age, sex, calendar year, and medical record number.
Main Results:
- Significant independent risk factors for VTE include surgery (OR, 21.7), trauma (OR, 12.7), and hospital/nursing home confinement (OR, 8.0).
- Malignant neoplasm (OR, 4.1-6.5), chemotherapy (OR, 6.5), central venous catheter/pacemaker (OR, 5.6), superficial vein thrombosis (OR, 4.3), and neurological disease with paresis (OR, 3.0) were also identified.
- Risk from varicose veins decreased with age; liver disease showed a reduced risk (OR, 0.1).
Conclusions:
- Hospital/nursing home confinement, surgery, trauma, malignant neoplasm, chemotherapy, neurologic disease with paresis, central venous catheter/pacemaker, varicose veins, and superficial vein thrombosis are confirmed as independent and significant risk factors for VTE.