Risk factors for deep vein thrombosis and pulmonary embolism: A population-based case-control study

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

Research output: Contribution to journalArticle

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Abstract

Background: Reported risk factors for venous thromboembolism (VTE) vary widely, and the magnitude and independence of each are uncertain. Objectives: To identify independent risk factors for deep vein thrombosis and pulmonary embolism and to estimate the magnitude of risk for each. Patients and Methods: We performed a population-based, nested, case-control study of 625 Olmsted County, Minnesota, patients with a first lifetime VTE diagnosed during the 15-year period from January 1, 1976, through December 31, 1990, and 625 Olmsted County patients without VTE. The 2 groups were matched on age, sex, calendar year, and medical record number. Results: Independent risk factors for VTE included surgery (odds ratio [OR], 21.7; 95% confidence interval [CI], 9.4-49.9), trauma (OR, 12.7; 95% CI, 4.1-39.7), hospital or nursing home confinement (OR, 8.0; 95% CI, 4.5-14.2), malignant neoplasm with (OR, 6.5; 95% CI, 2.1-20.2) or without (OR, 4.1; 95% CI, 1.9-8.5) chemotherapy, central venous catheter or pacemaker (OR, 5.6; 95% CI, 1.6- 19.6), superficial vein thrombosis (OR, 4.3; 95% CI, 1.8-10.6), and neurological disease with extremity paresis (OR, 3.0; 95% CI, 1.3-7.4). The risk associated with varicose veins diminished with age (for age 45 years: OR, 4.2; 95% CI, 1.6-11.3; for age 60 years: OR, 1.9; 95% CI, 1.0-3.6; for age 75 years: OR, 0.9; 95% CI, 0.64-1.4), while patients with liver disease had a reduced risk (OR, 0.1; 95% CI, 0.0-0.7). Conclusion: Hospital or nursing home confinement, surgery, trauma, malignant neoplasm, chemotherapy, neurologic disease with paresis, central venous catheter or pacemaker, varicose veins, and superficial vein thrombosis are independent and important risk factors for VTE.

Original languageEnglish (US)
Pages (from-to)809-815
Number of pages7
JournalArchives of Internal Medicine
Volume160
Issue number6
StatePublished - 2000

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Pulmonary Embolism
Venous Thrombosis
Case-Control Studies
Odds Ratio
Confidence Intervals
Population
Venous Thromboembolism
Central Venous Catheters
Varicose Veins
Paresis
Nursing Homes
Veins
Thrombosis
Drug Therapy
Wounds and Injuries
Nervous System Diseases
Medical Records
Liver Diseases
Neoplasms
Research Design

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Heit, J. A., Silverstein, M. D., Mohr, D. N., Petterson, T. M., O'Fallon, W. M., & Melton, L. J. (2000). Risk factors for deep vein thrombosis and pulmonary embolism: A population-based case-control study. Archives of Internal Medicine, 160(6), 809-815.

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

In: Archives of Internal Medicine, Vol. 160, No. 6, 2000, p. 809-815.

Research output: Contribution to journalArticle

Heit, JA, Silverstein, MD, Mohr, DN, Petterson, TM, O'Fallon, WM & Melton, LJ 2000, 'Risk factors for deep vein thrombosis and pulmonary embolism: A population-based case-control study', Archives of Internal Medicine, vol. 160, no. 6, pp. 809-815.
Heit JA, Silverstein MD, Mohr DN, Petterson TM, O'Fallon WM, Melton LJ. Risk factors for deep vein thrombosis and pulmonary embolism: A population-based case-control study. Archives of Internal Medicine. 2000;160(6):809-815.
Heit, John A. ; Silverstein, Marc D. ; Mohr, David N. ; Petterson, Tanya M. ; O'Fallon, W. Michael ; Melton, L. Joseph. / Risk factors for deep vein thrombosis and pulmonary embolism : A population-based case-control study. In: Archives of Internal Medicine. 2000 ; Vol. 160, No. 6. pp. 809-815.
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abstract = "Background: Reported risk factors for venous thromboembolism (VTE) vary widely, and the magnitude and independence of each are uncertain. Objectives: To identify independent risk factors for deep vein thrombosis and pulmonary embolism and to estimate the magnitude of risk for each. Patients and Methods: We performed a population-based, nested, case-control study of 625 Olmsted County, Minnesota, patients with a first lifetime VTE diagnosed during the 15-year period from January 1, 1976, through December 31, 1990, and 625 Olmsted County patients without VTE. The 2 groups were matched on age, sex, calendar year, and medical record number. Results: Independent risk factors for VTE included surgery (odds ratio [OR], 21.7; 95{\%} confidence interval [CI], 9.4-49.9), trauma (OR, 12.7; 95{\%} CI, 4.1-39.7), hospital or nursing home confinement (OR, 8.0; 95{\%} CI, 4.5-14.2), malignant neoplasm with (OR, 6.5; 95{\%} CI, 2.1-20.2) or without (OR, 4.1; 95{\%} CI, 1.9-8.5) chemotherapy, central venous catheter or pacemaker (OR, 5.6; 95{\%} CI, 1.6- 19.6), superficial vein thrombosis (OR, 4.3; 95{\%} CI, 1.8-10.6), and neurological disease with extremity paresis (OR, 3.0; 95{\%} CI, 1.3-7.4). The risk associated with varicose veins diminished with age (for age 45 years: OR, 4.2; 95{\%} CI, 1.6-11.3; for age 60 years: OR, 1.9; 95{\%} CI, 1.0-3.6; for age 75 years: OR, 0.9; 95{\%} CI, 0.64-1.4), while patients with liver disease had a reduced risk (OR, 0.1; 95{\%} CI, 0.0-0.7). Conclusion: Hospital or nursing home confinement, surgery, trauma, malignant neoplasm, chemotherapy, neurologic disease with paresis, central venous catheter or pacemaker, varicose veins, and superficial vein thrombosis are independent and important risk factors for VTE.",
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T1 - Risk factors for deep vein thrombosis and pulmonary embolism

T2 - A population-based case-control study

AU - Heit, John A.

AU - Silverstein, Marc D.

AU - Mohr, David N.

AU - Petterson, Tanya M.

AU - O'Fallon, W. Michael

AU - Melton, L. Joseph

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N2 - Background: Reported risk factors for venous thromboembolism (VTE) vary widely, and the magnitude and independence of each are uncertain. Objectives: To identify independent risk factors for deep vein thrombosis and pulmonary embolism and to estimate the magnitude of risk for each. Patients and Methods: We performed a population-based, nested, case-control study of 625 Olmsted County, Minnesota, patients with a first lifetime VTE diagnosed during the 15-year period from January 1, 1976, through December 31, 1990, and 625 Olmsted County patients without VTE. The 2 groups were matched on age, sex, calendar year, and medical record number. Results: Independent risk factors for VTE included surgery (odds ratio [OR], 21.7; 95% confidence interval [CI], 9.4-49.9), trauma (OR, 12.7; 95% CI, 4.1-39.7), hospital or nursing home confinement (OR, 8.0; 95% CI, 4.5-14.2), malignant neoplasm with (OR, 6.5; 95% CI, 2.1-20.2) or without (OR, 4.1; 95% CI, 1.9-8.5) chemotherapy, central venous catheter or pacemaker (OR, 5.6; 95% CI, 1.6- 19.6), superficial vein thrombosis (OR, 4.3; 95% CI, 1.8-10.6), and neurological disease with extremity paresis (OR, 3.0; 95% CI, 1.3-7.4). The risk associated with varicose veins diminished with age (for age 45 years: OR, 4.2; 95% CI, 1.6-11.3; for age 60 years: OR, 1.9; 95% CI, 1.0-3.6; for age 75 years: OR, 0.9; 95% CI, 0.64-1.4), while patients with liver disease had a reduced risk (OR, 0.1; 95% CI, 0.0-0.7). Conclusion: Hospital or nursing home confinement, surgery, trauma, malignant neoplasm, chemotherapy, neurologic disease with paresis, central venous catheter or pacemaker, varicose veins, and superficial vein thrombosis are independent and important risk factors for VTE.

AB - Background: Reported risk factors for venous thromboembolism (VTE) vary widely, and the magnitude and independence of each are uncertain. Objectives: To identify independent risk factors for deep vein thrombosis and pulmonary embolism and to estimate the magnitude of risk for each. Patients and Methods: We performed a population-based, nested, case-control study of 625 Olmsted County, Minnesota, patients with a first lifetime VTE diagnosed during the 15-year period from January 1, 1976, through December 31, 1990, and 625 Olmsted County patients without VTE. The 2 groups were matched on age, sex, calendar year, and medical record number. Results: Independent risk factors for VTE included surgery (odds ratio [OR], 21.7; 95% confidence interval [CI], 9.4-49.9), trauma (OR, 12.7; 95% CI, 4.1-39.7), hospital or nursing home confinement (OR, 8.0; 95% CI, 4.5-14.2), malignant neoplasm with (OR, 6.5; 95% CI, 2.1-20.2) or without (OR, 4.1; 95% CI, 1.9-8.5) chemotherapy, central venous catheter or pacemaker (OR, 5.6; 95% CI, 1.6- 19.6), superficial vein thrombosis (OR, 4.3; 95% CI, 1.8-10.6), and neurological disease with extremity paresis (OR, 3.0; 95% CI, 1.3-7.4). The risk associated with varicose veins diminished with age (for age 45 years: OR, 4.2; 95% CI, 1.6-11.3; for age 60 years: OR, 1.9; 95% CI, 1.0-3.6; for age 75 years: OR, 0.9; 95% CI, 0.64-1.4), while patients with liver disease had a reduced risk (OR, 0.1; 95% CI, 0.0-0.7). Conclusion: Hospital or nursing home confinement, surgery, trauma, malignant neoplasm, chemotherapy, neurologic disease with paresis, central venous catheter or pacemaker, varicose veins, and superficial vein thrombosis are independent and important risk factors for VTE.

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