Predictors of recurrence after deep vein thrombosis and pulmonary embolism: A population-based cohort study

John A. Heit, David N. Mohr, Marc D. Silverstein, Tanya M. Petterson, W. Michael O'Fallon, L. Joseph Melton

Research output: Contribution to journalArticle

679 Citations (Scopus)

Abstract

Background: The appropriate duration of oral anticoagulation after a first episode of venous thromboembolism (VTE) is uncertain and depends upon VTE recurrence rates. Objective: To estimate VTE recurrence rates and determine predictors of recurrence. Methods: Patients in Olmsted County, Minnesota, with a first lifetime deep vein thrombosis or pulmonary embolism diagnosed during the 25-year period from 1966 through 1990 (N = 1719) were followed forward in time through their complete medical records in the community for first VTE recurrence. Results: Four hundred four patients developed recurrent VTE during 10 198 person-years of follow-up. The overall (probable/definite) cumulative percentages of VTE recurrence at 7, 30, and 180 days and i and 10 years were 1.6% (0.2%), 5.2% (1.4%), 10.1% (4.1%), 12.9% (5.6%), and 30.4% (17.6%), respectively. The risk of recurrence was greatest in the first 6 to 12 months after the initial event but never fell to zero. Independent predictors of first overall VTE recurrence included increasing age and body mass index, neurologic disease with paresis, malignant neoplasm, and neurosurgery during the period from 1966 through 1980. Independent predictors of first probable/definite recurrence included diagnostic certainty of the incident event and neurologic disease in patients with hospital-acquired VTE. Recurrence risk was increased by malignant neoplasm but varied with concomitant chemotherapy, patient age and sex, and study year. Conclusions: Venous thromboembolism recurs frequently, especially within the first 6 to 12 months, and continues to recur for at least 10 years after the initial VTE. Patients with VTE with neurologic disease and paresis or with malignant neoplasm are at increased risk for recurrence, while VTE patients with transient or reversible risk factors are at less risk.

Original languageEnglish (US)
Pages (from-to)761-768
Number of pages8
JournalArchives of Internal Medicine
Volume160
Issue number6
StatePublished - 2000

Fingerprint

Venous Thromboembolism
Pulmonary Embolism
Venous Thrombosis
Cohort Studies
Recurrence
Population
Nervous System Diseases
Paresis
Medical Errors
Neoplasms
Neurosurgery
Medical Records
Body Mass Index

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Heit, J. A., Mohr, D. N., Silverstein, M. D., Petterson, T. M., O'Fallon, W. M., & Melton, L. J. (2000). Predictors of recurrence after deep vein thrombosis and pulmonary embolism: A population-based cohort study. Archives of Internal Medicine, 160(6), 761-768.

Predictors of recurrence after deep vein thrombosis and pulmonary embolism : A population-based cohort study. / Heit, John A.; Mohr, David N.; Silverstein, Marc D.; Petterson, Tanya M.; O'Fallon, W. Michael; Melton, L. Joseph.

In: Archives of Internal Medicine, Vol. 160, No. 6, 2000, p. 761-768.

Research output: Contribution to journalArticle

Heit, JA, Mohr, DN, Silverstein, MD, Petterson, TM, O'Fallon, WM & Melton, LJ 2000, 'Predictors of recurrence after deep vein thrombosis and pulmonary embolism: A population-based cohort study', Archives of Internal Medicine, vol. 160, no. 6, pp. 761-768.
Heit JA, Mohr DN, Silverstein MD, Petterson TM, O'Fallon WM, Melton LJ. Predictors of recurrence after deep vein thrombosis and pulmonary embolism: A population-based cohort study. Archives of Internal Medicine. 2000;160(6):761-768.
Heit, John A. ; Mohr, David N. ; Silverstein, Marc D. ; Petterson, Tanya M. ; O'Fallon, W. Michael ; Melton, L. Joseph. / Predictors of recurrence after deep vein thrombosis and pulmonary embolism : A population-based cohort study. In: Archives of Internal Medicine. 2000 ; Vol. 160, No. 6. pp. 761-768.
@article{f79298e6f3814b7aaa3e3bb52aeda248,
title = "Predictors of recurrence after deep vein thrombosis and pulmonary embolism: A population-based cohort study",
abstract = "Background: The appropriate duration of oral anticoagulation after a first episode of venous thromboembolism (VTE) is uncertain and depends upon VTE recurrence rates. Objective: To estimate VTE recurrence rates and determine predictors of recurrence. Methods: Patients in Olmsted County, Minnesota, with a first lifetime deep vein thrombosis or pulmonary embolism diagnosed during the 25-year period from 1966 through 1990 (N = 1719) were followed forward in time through their complete medical records in the community for first VTE recurrence. Results: Four hundred four patients developed recurrent VTE during 10 198 person-years of follow-up. The overall (probable/definite) cumulative percentages of VTE recurrence at 7, 30, and 180 days and i and 10 years were 1.6{\%} (0.2{\%}), 5.2{\%} (1.4{\%}), 10.1{\%} (4.1{\%}), 12.9{\%} (5.6{\%}), and 30.4{\%} (17.6{\%}), respectively. The risk of recurrence was greatest in the first 6 to 12 months after the initial event but never fell to zero. Independent predictors of first overall VTE recurrence included increasing age and body mass index, neurologic disease with paresis, malignant neoplasm, and neurosurgery during the period from 1966 through 1980. Independent predictors of first probable/definite recurrence included diagnostic certainty of the incident event and neurologic disease in patients with hospital-acquired VTE. Recurrence risk was increased by malignant neoplasm but varied with concomitant chemotherapy, patient age and sex, and study year. Conclusions: Venous thromboembolism recurs frequently, especially within the first 6 to 12 months, and continues to recur for at least 10 years after the initial VTE. Patients with VTE with neurologic disease and paresis or with malignant neoplasm are at increased risk for recurrence, while VTE patients with transient or reversible risk factors are at less risk.",
author = "Heit, {John A.} and Mohr, {David N.} and Silverstein, {Marc D.} and Petterson, {Tanya M.} and O'Fallon, {W. Michael} and Melton, {L. Joseph}",
year = "2000",
language = "English (US)",
volume = "160",
pages = "761--768",
journal = "JAMA Internal Medicine",
issn = "2168-6106",
publisher = "American Medical Association",
number = "6",

}

TY - JOUR

T1 - Predictors of recurrence after deep vein thrombosis and pulmonary embolism

T2 - A population-based cohort study

AU - Heit, John A.

AU - Mohr, David N.

AU - Silverstein, Marc D.

AU - Petterson, Tanya M.

AU - O'Fallon, W. Michael

AU - Melton, L. Joseph

PY - 2000

Y1 - 2000

N2 - Background: The appropriate duration of oral anticoagulation after a first episode of venous thromboembolism (VTE) is uncertain and depends upon VTE recurrence rates. Objective: To estimate VTE recurrence rates and determine predictors of recurrence. Methods: Patients in Olmsted County, Minnesota, with a first lifetime deep vein thrombosis or pulmonary embolism diagnosed during the 25-year period from 1966 through 1990 (N = 1719) were followed forward in time through their complete medical records in the community for first VTE recurrence. Results: Four hundred four patients developed recurrent VTE during 10 198 person-years of follow-up. The overall (probable/definite) cumulative percentages of VTE recurrence at 7, 30, and 180 days and i and 10 years were 1.6% (0.2%), 5.2% (1.4%), 10.1% (4.1%), 12.9% (5.6%), and 30.4% (17.6%), respectively. The risk of recurrence was greatest in the first 6 to 12 months after the initial event but never fell to zero. Independent predictors of first overall VTE recurrence included increasing age and body mass index, neurologic disease with paresis, malignant neoplasm, and neurosurgery during the period from 1966 through 1980. Independent predictors of first probable/definite recurrence included diagnostic certainty of the incident event and neurologic disease in patients with hospital-acquired VTE. Recurrence risk was increased by malignant neoplasm but varied with concomitant chemotherapy, patient age and sex, and study year. Conclusions: Venous thromboembolism recurs frequently, especially within the first 6 to 12 months, and continues to recur for at least 10 years after the initial VTE. Patients with VTE with neurologic disease and paresis or with malignant neoplasm are at increased risk for recurrence, while VTE patients with transient or reversible risk factors are at less risk.

AB - Background: The appropriate duration of oral anticoagulation after a first episode of venous thromboembolism (VTE) is uncertain and depends upon VTE recurrence rates. Objective: To estimate VTE recurrence rates and determine predictors of recurrence. Methods: Patients in Olmsted County, Minnesota, with a first lifetime deep vein thrombosis or pulmonary embolism diagnosed during the 25-year period from 1966 through 1990 (N = 1719) were followed forward in time through their complete medical records in the community for first VTE recurrence. Results: Four hundred four patients developed recurrent VTE during 10 198 person-years of follow-up. The overall (probable/definite) cumulative percentages of VTE recurrence at 7, 30, and 180 days and i and 10 years were 1.6% (0.2%), 5.2% (1.4%), 10.1% (4.1%), 12.9% (5.6%), and 30.4% (17.6%), respectively. The risk of recurrence was greatest in the first 6 to 12 months after the initial event but never fell to zero. Independent predictors of first overall VTE recurrence included increasing age and body mass index, neurologic disease with paresis, malignant neoplasm, and neurosurgery during the period from 1966 through 1980. Independent predictors of first probable/definite recurrence included diagnostic certainty of the incident event and neurologic disease in patients with hospital-acquired VTE. Recurrence risk was increased by malignant neoplasm but varied with concomitant chemotherapy, patient age and sex, and study year. Conclusions: Venous thromboembolism recurs frequently, especially within the first 6 to 12 months, and continues to recur for at least 10 years after the initial VTE. Patients with VTE with neurologic disease and paresis or with malignant neoplasm are at increased risk for recurrence, while VTE patients with transient or reversible risk factors are at less risk.

UR - http://www.scopus.com/inward/record.url?scp=0343674485&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0343674485&partnerID=8YFLogxK

M3 - Article

C2 - 10737275

AN - SCOPUS:0343674485

VL - 160

SP - 761

EP - 768

JO - JAMA Internal Medicine

JF - JAMA Internal Medicine

SN - 2168-6106

IS - 6

ER -