Age- and sex-specific incidence, risk, and latency period of a perioperative acute thromboembolism syndrome (PATS)

2004 ◽  
Vol 91 (04) ◽  
pp. 725-732 ◽  
Author(s):  
Tomosue Takada ◽  
Shigehito Sato ◽  
Mutsuhito Kikura
Keyword(s):  
Myocardial Infarction ◽  
Pulmonary Embolism ◽  
Confidence Interval ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Odds Ratio ◽  
Latency Period ◽  
Percent Confidence Interval ◽  
Increased Risk ◽  
Incidence Risk

SummaryWe investigated age- and sex-specific incidence, risk factors, and latency period of a perioperative acute thromboembolism syndrome (PATS) in a large cohort study. We prospectively analyzed data on 21903 consecutive surgery patients to determine the incidence of myocardial infarction, pulmonary embolism, deep venous thrombosis, stroke, and cardiovascular death within 30 postoperative days. Among 255 (1.2 percent) patients with thromboembolism, 105 (0.48 percent) suffered myocardial infarction (mean latency: 5 days), 30 (0.14 percent) suffered pulmonary embolism (6 days), 23 (0.11 percent) suffered deep venous thrombosis (10 days), 97 (0.44 percent) suffered stroke (11 days), and 13 (0.06 percent) died (12 days). The critical period was postoperative week 1 for myocardial infarction and pulmonary embolism, and postoperative week 1 and 2 for deep venous thrombosis, stroke, and death. Risk of all events increased with age (P<0.0001), particularly for over 70 years (odds ratio: 12.5; 95 percent confidence interval, 7.8 to 19.9). Males had an increased risk (P<0.0001) of myocardial infarction (odds ratio; 1.5; 95 percent confidence interval, 1.0 to 2.3). Females had an increased risk (P<0.0001) of pulmonary embolism (odds ratio: 2.7; 95 percent confidence interval, 1.3 to 5.9) and deep venous thrombosis (odds ratio: 9.8; 95 percent confidence interval, 3.3 to 29.3). Risk of thromboembolic event was higher (P<0.0001) in patients with a history of arterial thrombotic events or cancer. Trend analysis indicates that thromboembolic events will increase 3-fold over the next decade. Our findings enable identification of higher risk patients for prophylactic anti-thromboembolic treatment and awareness of the critical postoperative period.

Frequency of Myocardial Infarction, Pulmonary Embolism, Deep Venous Thrombosis, and Death following Primary Hip or Knee Arthroplasty

2002 ◽  
Vol 96 (5) ◽  
pp. 1140-1146 ◽  
Author(s):  
Margaret Wood ◽  
Carlos B. Mantilla ◽  
Terese T. Horlocker ◽  
Darrell R. Schroeder ◽  
Daniel J. Berry ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Pulmonary Embolism ◽  
Adverse Events ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Knee Arthroplasty ◽  
Perioperative Complications ◽  
Total Hip ◽  
Diagnostic Certainty ◽  
Contemporary Practice

Background There is limited information about the frequency of perioperative complications after elective primary orthopedic total hip and knee arthroplasty in contemporary practice. The purpose of this study was to determine the frequency of clinically relevant myocardial infarction, pulmonary embolism, deep venous thrombosis, and death within 30 days after elective primary hip or knee arthroplasty treated according to contemporary perioperative management. Methods The authors examined the medical records of consecutive patients undergoing hip or knee arthroplasty at their institution in a 10-yr period. Prospectively collected databases were used to identify patients with the diagnosis of myocardial infarction, pulmonary embolism, deep venous thrombosis, or death using strict validation criteria and diagnostic-certainty categories. Results A total of 10,244 patients underwent primary total hip or knee arthroplasty in the period of study. Of these, 224 patients had one or more adverse events (overall event rate: 2.2%; myocardial infarction: 0.4%; pulmonary embolism: 0.7%; deep venous thrombosis: 1.5%; death: 0.5%). Most adverse events (myocardial infarction, pulmonary embolism, and death) increased in frequency with older age, particularly for patients aged 70 yr or older. Myocardial infarction occurred more frequently in male patients. There were no differences in the overall event frequency between types of procedure. However, pulmonary embolism was highest in patients undergoing bilateral knee operations. Conclusions The overall frequency of serious complications within 30 days after primary total hip or knee arthroplasty with contemporary practice was 2.2%. Accurate knowledge of the perioperative risks associated with widely performed elective operations can be used to implement management strategies that may further improve patient outcomes and decrease cost.

scholarly journals Risk of pulmonary embolism and deep venous thrombosis in patients with asthma: a nationwide case−control study from Sweden

2017 ◽  
Vol 49 (2) ◽  
pp. 1601014 ◽  
Author(s):  
Bengt Zöller ◽  
Mirnabi Pirouzifard ◽  
Ashfaque A. Memon ◽  
Jan Sundquist ◽  
Kristina Sundquist
Keyword(s):  
Pulmonary Embolism ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Case Control Study ◽  
Conditional Logistic Regression ◽  
Case Control ◽  
Increased Risk ◽  
Using Data ◽  
Population Controls ◽  
Control Study

Asthma is associated with an increased risk of pulmonary embolism (PE) but little is known about whether asthma is associated with an increased risk of deep venous thrombosis (DVT). The aim in this study was to determine the risk of the first event of PE, DVT or a combination of PE and DVT in patients with asthma.We conducted this nationwide case–control study using data from Swedish nationwide registries. We included 114 366 Swedish-born patients with a first hospital diagnosis of PE, 76 494 patients with DVT and 6854 patients with both PE and DVT in Sweden between 1981 and 2010. We also included five age-, sex- and education-matched population controls. All previous hospital diagnoses of asthma were identified. Conditional logistic regression was used to compute odds ratios with adjustment for potential confounders.Asthma was associated with an adjusted odds ratio for PE of 1.43 (95% CI 1.37–1.50), for DVT of 1.56 (95% CI 1.47–1.65) and for combined PE and DVT of 1.60 (95% CI 1.32–1.93). Asthma was associated with an increased risk of PE, DVT and combined PE and DVT.Thus, the inflammation conferred by asthma seems to have systemic (and not just local) prothrombotic effects with increased risk of both DVT and PE.

Risk factors associated with the occurrence of silent pulmonary embolism in patients with deep venous thrombosis of the lower limb

2013 ◽  
Vol 29 (7) ◽  
pp. 442-446 ◽  
Author(s):  
Fenghe Li ◽  
Xuehu Wang ◽  
Wen Huang ◽  
Wei Ren ◽  
Jun Cheng ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pulmonary Embolism ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Odds Ratio ◽  
Heart Diseases ◽  
Lower Limbs ◽  
Chi Square ◽  
Chi Square Test ◽  
The Right

Objective The aim of our study is to investigate the prevalence of silent pulmonary embolism in patients with deep venous thrombosis in the lower limbs and to evaluate the associated risk factors. Methods A total of 322 patients with acute deep venous thrombosis confirmed by CT venography or Doppler ultrasonography were studied. The diagnosis of silent pulmonary embolism was established by computed tomography pulmonary arteriography (CTPA). The association between covariates and the prevalence of silent pulmonary embolism in patients with deep venous thrombosis in lower limbs were assessed using chi-square test and multivariable regression. Results The incidence of silent pulmonary embolism was 33.5% (108 in 322 patients) in all patients with deep venous thrombosis in lower limbs. Chi-square test showed male gender, the right lower limb, proximal location of the thrombus, unprovoked venous thrombosis and coexisting heart diseases were related to a higher incidence of silent pulmonary embolism in patients with deep venous thrombosis in lower limbs. The multivariate regression analysis confirmed that the risk factors associated with silent pulmonary embolism in deep venous thrombosis patients included the right side and proximal location of the thrombus (odds ratio: 2.023, 95% CI: 1.215–3.368; odds ratio: 3.610, 95% CI: 1.772–7.354), unprovoked venous thrombosis (odds ratio: 2.037, 95% CI: 1.188–3.493), coexisting heart diseases (odds ratio: 4.507, 95% CI: 2.667–7.618). Conclusion Silent pulmonary embolism occurred frequently in patients with deep venous thrombosis in lower limbs. The right side, the proximal location of the thrombus, unprovoked venous thrombosis and coexisting heart diseases increased the risk for the occurrence of silent pulmonary embolism.

Increased Risk of Deep Venous Thrombosis and Pulmonary Embolism in Patients Infected With Clostridium difficile

2015 ◽  
Vol 110 ◽  
pp. S554
Author(s):  
Sanjay Bhandari ◽  
Muhammad Shahreyar ◽  
Mashooque Ali Dahar ◽  
Ahmad Hanif ◽  
Thangam Venkatesan ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Clostridium Difficile ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Increased Risk

Deep Venous Thrombosis and Pulmonary Embolism in Acute Myocardial Infarction

2015 ◽  
pp. 113-119
Author(s):  
P. Niederle ◽  
I. Prerovsk� ◽  
J. šimonov� ◽  
V. št�dlerov� ◽  
M. Riedel ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Pulmonary Embolism ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis

Incidence of Venous Thromboembolism: A Community-based Study in Western France

2000 ◽  
Vol 83 (05) ◽  
pp. 657-660 ◽  
Author(s):  
Emmanuel Oger ◽  
Keyword(s):  
Pulmonary Embolism ◽  
Venous Thromboembolism ◽  
High Risk ◽  
Confidence Interval ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Medical Patients ◽  
Community Based ◽  
Effective Prophylaxis ◽  
One Year

SummaryThe incidence of venous thromboembolism has been studied during one year in a defined population of 342,000 inhabitants. The overall incidence (95% confidence interval) of venous thromboembolism was found to be 1.83 per thousand per year (1.69 to 1.98). The incidences of deep venous thrombosis and pulmonary embolism were 1.24 per thousand per year (1.12 to 1.36) and 0.60 per thousand per year (0.52 to 0.69), respectively. The incidence of venous thromboembolism rose markedly with increasing age for both sexes; over the age of 75, the annual incidence reached 1 per 100. Sixty three percent of the patients were at home when venous thromboembolism occurred. Of these, sixteen percent had been previously hospitalised within three months. These results raise concerns on identification of medical patients at high risk and effective prophylaxis.

scholarly journals Minor Events and the Risk of Deep Venous Thrombosis

2000 ◽  
Vol 83 (03) ◽  
pp. 408-411 ◽  
Author(s):  
E. M. W. Eekhoff ◽  
J. P. Vandenbroucke ◽  
F. R. Rosendaal
Keyword(s):  
Risk Factors ◽  
Confidence Interval ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Odds Ratio ◽  
Factor V Leiden ◽  
Common Disease ◽  
Factor V ◽  
Factor V Leiden Mutation ◽  
Synergy Index

SummaryBackground Deep venous thrombosis is a common disease, with genetic and acquired risk factors. Many patients have a history of minor events (short periods of immobilisation such as prolonged travel, short illness, minor surgery or injuries) before onset of venous thrombosis. However, the role of these minor events has received little formal study. Also, we do not know how minor events might interact with the presence of genetic prothrombotic defects (factor V Leiden mutation, factor II mutation, protein C, S and antithrombin deficiency). Patients and Methods On the basis of case-control data from a thrombosis service in the Netherlands, we added a follow-up period for a casecross-over analysis of minor events as risk factors, and a case-only analysis for the interaction with factor V Leiden. A total of 187 patients with first, objectively diagnosed venous thrombosis of the legs, aged 15–70, without underlying malignancies and without major acquired risk factors entered the study. For the analysis of minor events in the case-cross-over analysis, we used a matched odds ratio; in the caseonly analysis, we used the multiplicative synergy index. Results In 32.6% of the 187 patients with deep venous thrombosis who did not have major acquired risk factors, minor events were the only external risk factors. Minor events increased the risk of thrombosis about 3-fold, as estimated in the case-cross-over analysis (odds ratio 2.9, 95% confidence interval 1.5–5.4). The synergy index between minor events and factor V Leiden mutation in the case-only analysis was 0.7 (95% confidence interval 0.3–1.5). Therefore, persons with factor V Leiden mutation who experience a minor event will have an estimated risk increase of about 17-fold, which exceeds the sum of the individual risk factors. Conclusions Minor events are likely to play an important role in the development of deep venous thrombosis, especially in the presence of genetic prothrombotic conditions.

Sign in / Sign up

Export Citation Format

Share Document