Relative impact of risk factors for deep vein thrombosis and pulmonary embolism

A population-based study

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

Research output: Contribution to journalArticle

752 Citations (Scopus)

Abstract

Objective: To assess the potential impact of controlling risk factors on the incidence of venous thromboembolism by estimating the population attributable risk (defined as the percentage of all cases of a disease in a population that can be "attributed" to a risk factor) for deep vein thrombosis and pulmonary embolism associated with venous thromboembolism risk factors. Methods: Using data from a population-based, nested, case-control study of the 625 Olmsted County, Minnesota, residents with a definite first lifetime deep vein thrombosis or pulmonary embolism diagnosed during the 15-year period 1976 to 1990 and 625 unaffected Olmsted County residents matched for age and sex, we developed a conditional logistic regression model appropriate to the matched case-control study design and then estimated attributable risk for the risk factors individually and collectively. Results: Fifty-nine percent of the cases of venous thromboembolism in the community could be attributed to institutionalization (current or recent hospitalization or nursing home residence). Hospitalization for surgery (24%) and for medical illness (22%) accounted for a similar proportion of the cases, while nursing home residence accounted for 13%. The individual attributable risk estimates for malignant neoplasm, trauma, congestive heart failure, central venous catheter or pacemaker placement, neurological disease with extremity paresis, and superficial vein thrombosis were 18%, 12%, 10%, 9%, 7%, and 5%, respectively. Together, the 8 risk factors accounted for 74% of disease occurrence. Conclusions: Factors associated with institutionalization independently account for more than 50% of all cases of venous thromboembolism in the community. Greater emphasis should be placed on prophylaxis for hospitalized medical patients. Other recognized risk factors account for about 25% of all cases of venous thromboembolism, while the remaining 25% of cases are idiopathic.

Original languageEnglish (US)
Pages (from-to)1245-1248
Number of pages4
JournalArchives of Internal Medicine
Volume162
Issue number11
StatePublished - Jun 10 2002

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Pulmonary Embolism
Venous Thrombosis
Venous Thromboembolism
Population
Institutionalization
Nursing Homes
Case-Control Studies
Hospitalization
Logistic Models
Central Venous Catheters
Paresis
Veins
Thrombosis
Extremities
Heart Failure
Incidence
Wounds and Injuries
Neoplasms

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Heit, J. A., Michael O'Fallon, W., Petterson, T. M., Lohse, C. M., Silverstein, M. D., Mohr, D. N., & Joseph Melton, L. (2002). Relative impact of risk factors for deep vein thrombosis and pulmonary embolism: A population-based study. Archives of Internal Medicine, 162(11), 1245-1248.

Relative impact of risk factors for deep vein thrombosis and pulmonary embolism : A population-based study. / Heit, John A.; Michael O'Fallon, W.; Petterson, Tanya M.; Lohse, Christine M.; Silverstein, Marc D.; Mohr, David N.; Joseph Melton, L.

In: Archives of Internal Medicine, Vol. 162, No. 11, 10.06.2002, p. 1245-1248.

Research output: Contribution to journalArticle

Heit, JA, Michael O'Fallon, W, Petterson, TM, Lohse, CM, Silverstein, MD, Mohr, DN & Joseph Melton, L 2002, 'Relative impact of risk factors for deep vein thrombosis and pulmonary embolism: A population-based study', Archives of Internal Medicine, vol. 162, no. 11, pp. 1245-1248.
Heit JA, Michael O'Fallon W, Petterson TM, Lohse CM, Silverstein MD, Mohr DN et al. Relative impact of risk factors for deep vein thrombosis and pulmonary embolism: A population-based study. Archives of Internal Medicine. 2002 Jun 10;162(11):1245-1248.
Heit, John A. ; Michael O'Fallon, W. ; Petterson, Tanya M. ; Lohse, Christine M. ; Silverstein, Marc D. ; Mohr, David N. ; Joseph Melton, L. / Relative impact of risk factors for deep vein thrombosis and pulmonary embolism : A population-based study. In: Archives of Internal Medicine. 2002 ; Vol. 162, No. 11. pp. 1245-1248.
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AU - Lohse, Christine M.

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