Risk Indicators for Osteomyelitis versus Osteitis on MRI

Category: Other Introduction/Purpose: Magnetic resonance imaging (MRI) is the most accurate modality for identifying osteomyelitis with prior literature reporting sensitivities and specificities of 90% and 80%, respectively. MRI findings consistent with osteomyelitis include bone marrow edema, hyperintensity on T2-weighted images (T2WI), and confluent signal on T1-weighted images (T1WI). Additional radiographic indicators include superficial ulceration, exposed bone, and cortical erosion. What is unclear is which of these factors, alone or in combination, is most closely associated with a diagnosis of osteomyelitis. The goal of the current study is to determine which clinical risk factors and MRI findings are most predictive of osteomyelitis. Methods: After IRB approval, clinical records of one hundred five patients who underwent bone biopsy of the foot or ankle between 2015-2017 were retrospectively examined. Patients who did not obtain MRI within 30 days preceding bone biopsy were excluded. A total of 65 patients were included. Diagnosis of osteomyelitis was determined by histology. Blinded radiologic review of MRI was performed to evaluate presence of 4 key indicators of osteomyelitis: hyperintensity on T2WI, confluent signal on T1WI, depth of ulceration, and presence of cortical erosion. Bivariate Poisson regression with robust error variance was used to determine if an association existed between the incidence of osteomyelitis and patient comorbidities and radiographic indicators. A multivariate Poisson regression including patient and radiographic indicators as controls was performed using backwards, stepwise regression until only variables with p<0.05 remained. Results: Of 65 subjects, 41 (63.1%) and 24 (36.9%) had pathologic evidence of osteomyelitis or indeterminate results, respectively. The sensitivity (Se) and specificity (Sp) for osteomyelitis versus osteitis by radiologist heuristic was 51.4% and 77.8%, respectively. The sensitivity and specificity for hyperintensity on T2WI (Se:90.2%; Sp:16.7%), confluent signal on T1WI (Se:43.9%; Sp:83.3%), depth of ulceration (Se:78.0%; Sp:41.7%), and cortical erosion (Se:41.5%; Sp:79.2%) are detailed. Bivariate analysis determined diabetes (Relative risk [RR]=3.2, 95% Confidence Interval [CI]=1.14-8.72, p=0.026) and confluent signal on T1WI (RR=1.5, 95%CI=1.08-2.16, p=0.015) were risk factors for osteomyelitis. An immunocompromised state and presence of cortical erosion were trending towards statistical significance. Multivariate analysis determined an immunocompromised state (RR=1.8, 95%CI=1.32-2.39, p=<0.001) and confluent signal on T1WI (RR=1.6, 95%CI=1.08-2.28, p=0.019) to be independent risk factors for osteomyelitis. Conclusion: The results of this study demonstrate that confluence of signal on T1WI and an immunocompromised state were independent risk factors for osteomyelitis. Additionally, patients with evidence of cortical erosion or diabetes should be more thoroughly evaluated if clinical concern for osteomyelitis is high. Patients with these comorbidities or radiographic indicators should undergo bone biopsy for definitive diagnosis.

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MRI and Clinical Risk Indicators for Osteomyelitis

Foot & Ankle Specialist ◽

10.1177/1938640020921572 ◽

2020 ◽

pp. 193864002092157

Author(s):

Dustin H. Massel ◽

Nathaniel W. Jenkins ◽

Augustus J. Rush ◽

Justin E. Trapana ◽

Gregory B. Foremny ◽

...

Keyword(s):

Risk Factors ◽

Sensitivity And Specificity ◽

Bone Biopsy ◽

Statistical Significance ◽

Risk Indicators ◽

Bivariate Analysis ◽

Mri Findings ◽

Weighted Image ◽

Independent Risk Factors ◽

Retrospective Comparative Study

Introduction. The sensitivity and specificity for magnetic resonance imaging (MRI) diagnosis of osteomyelitis is 90% and 80%, respectively; findings include bone marrow edema, T2-weighted image hyperintensity (HI-T2WI), T1-weighted image confluent signal(CS-T1WI), and cortical erosion (CE). The goal is to determine which risk factors and MRI findings are most predictive of osteomyelitis. Materials and Methods. After institutional review board approval, records of patients who underwent bone biopsy of the foot/ankle between 2015 and 2017 were reviewed. Diagnosis was determined histologically. Blinded MRI review identified indicators of osteomyelitis: HI-T2WI, CS-T1WI, ulcer depth, and CE. Bivariate and multivariate regression determined an association between osteomyelitis and radiographic indicators. Results. Of 59 subjects, 41 (69.5%) and 18 (30.5%) had pathologic evidence of osteomyelitis or were indeterminate. The sensitivity and specificity by radiologist diagnosis was 51.4% and 91.7%, respectively. Diabetes (relative risk [RR]=2.9, 95% CI = 1.0.8-7.77, P = .034), CS-T1WI (RR = 1.6, 95% CI = 1.23-2.20, P < .001), and CE (RR = 1.8, 95% CI = 1.34-2.28, P < .001) were risk factors on bivariate analysis. Ulcer depth demonstrated a trend toward statistical significance. Diabetes (RR = 2.4, 95% CI = 1.00-5.69, P = .049) and CE (RR = 1.7, 95% CI = 1.27-2.37, P < .001) were independent risk factors on multivariate analysis. Discussion. Diabetes and CS-T1WI are independent risk factors for pedal osteomyelitis. Patients with diabetes, CS-T1WI, and CE should be evaluated for osteomyelitis with recommendation for bone biopsy in appropriate clinical settings. Levels of Evidence: Level III Retrospective Comparative Study

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Psychosocial Factors Associated with Peptic Ulcer in Aged Persons

Psychological Reports ◽

10.2466/pr0.1999.85.3.761 ◽

1999 ◽

Vol 85 (3) ◽

pp. 761-769 ◽

Cited By ~ 2

Author(s):

Midori Furuse ◽

Kazuhiro Yoshiuchi ◽

Hiroaki Kumano ◽

Yuichi Yamauchi

Keyword(s):

Risk Factors ◽

Peptic Ulcer ◽

Elderly People ◽

Psychosocial Factors ◽

Elderly Women ◽

Statistical Significance ◽

Physical Risk ◽

Physical Risk Factors ◽

Clinical Records ◽

The Relationship

The relationship between psychosocial factors and the occurrence and aggravation of peptic ulcer was studied in elderly people Thirty nine (14 male) ulcer patients and 79 (30 male) elderly people aged 65 years and over and living in the community were tested. Information on health status, medication, lifestyle, and psychosocial status was obtained by means of interviews using a questionnaire and from the clinical records of the ulcer patients. The same questionnaire was distributed to the residents. Logistic regression analysis adjusting for age disclosed that peptic ulcer was significantly associated with having an occupation and low exercise practice in men. However, the relationship weakened below statistical significance after adjusting for some physical risk factors besides age. Low education was significant but low instrumental support fell short of statistical significance with peptic ulcer in women even after adjustment for several physical risk factors besides age. Thus, the specific psychosocial factors might be independently associated with the occurrence and aggravation of peptic ulcer in at least elderly women.

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Risk Factors Associated with Statin-Associated Muscle Symptoms in Patients Attending a Specialized Regional Lipid Clinic

Journal of Lipids ◽

10.1155/2021/8882706 ◽

2021 ◽

Vol 2021 ◽

pp. 1-5

Author(s):

M. K. Saeed ◽

J. Shah ◽

R. Damani ◽

F. Rahman ◽

P. Patel ◽

...

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Statistical Significance ◽

University Hospitals ◽

Antihypertensive Medications ◽

Factors Associated ◽

Binomial Logistic Regression ◽

Lipid Clinic ◽

The Uk ◽

Clinical Records

Background. Statin-associated muscle symptoms (SAMS) are the major side effects reported for statins. Data from previous studies suggest that 7–29% of patients on statin had associated muscle symptoms. In the UK, there is a lack of corresponding data on SAMS and factors associated with the development of SAMS. Objective. This analysis is aimed at establishing the prevalence of SAMS and identifying major contributory risk factors in patients attending a lipid clinic. Methods. Clinical records of 535 consecutive patients, who visited the lipid clinic in the University Hospitals of Leicester, were studied retrospectively between 2009 and 2012. SAMS were defined by the presence of muscle symptoms with two or more different statins. Patients who reported muscle symptoms to statin with one or no rechallenge were excluded. The association of SAMS with clinical characteristics such as age and BMI, sex, smoking, excess alcohol, comorbidities, and medications was tested for statistical significance. A binomial logistic regression model was applied to adjust for risk factors significantly associated with SAMS. Results. The prevalence of SAMS was found to be 11%. On unadjusted analysis, the mean age of patients who had SAMS was significantly higher than those without SAMS ( 59.4 ± 10.5 years vs. 50.3 ± 13.4 years, respectively, P < 0.001 ). Nonsmokers were more likely to develop SAMS in comparison to active smokers ( P = 0.037 ). Patients taking antihypertensive medications were more likely to develop SAMS ( P = 0.010 ). In binomial logistic regression analysis, only age was positively and significantly associated with SAMS after adjusting for other risk factors ( β = 0.054 , P = 0.001 ). Conclusion. To the best of our knowledge, this study is the largest cohort of patients with SAMS in the United Kingdom. Our data suggest that the prevalence of SAMS is 11% and increased age is a risk factor associated with the development of SAMS in our cohort of patients.

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Adjusted Morbidity Groups and Intracerebral Haemorrhage: A Retrospective Primary Care Cohort Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph182413320 ◽

2021 ◽

Vol 18 (24) ◽

pp. 13320

Author(s):

Blanca Lorman-Carbó ◽

Josep Lluis Clua-Espuny ◽

Eulalia Muria-Subirats ◽

Juan Ballesta-Ors ◽

Maria Antònia González-Henares ◽

...

Keyword(s):

Risk Factors ◽

Cohort Study ◽

Intracerebral Haemorrhage ◽

Antiplatelet Agents ◽

Community Based ◽

Group 4 ◽

Complex Patients ◽

History Of ◽

Independent Risk Factors ◽

Clinical Records

Background: Intracerebral haemorrhage rates are increasing among highly complex, elderly patients. The main objective of this study was to identify modifiable risk factors of intracerebral haemorrhage. Methods: Multicentre, retrospective, community-based cohort study was conducted, including patients in the Adjusted Morbidity Group 4 with no history of intracerebral haemorrhage. Cases were obtained from electronic clinical records of the Catalan Institute of Health and were followed up for five years. The primary outcome was the occurrence of intracerebral haemorrhage during the study period. Demographic, clinical and pharmacological variables were included. Logistic regression analyses were carried out to detect prognostic variables for intracerebral haemorrhage. Results: 4686 subjects were included; 170 (3.6%) suffered an intracerebral haemorrhage (85.8/10,000 person–year [95% CI 85.4 to 86.2]). The HAS-BLED score for intracerebral haemorrhage risk detection obtained the best AUC (0.7) when used in the highest complexity level (cut-off point ≥3). Associated independent risk factors were age ≥80 years, high complexity and use of antiplatelet agents. Conclusions: The Adjusted Morbidity Group 4 is associated with a high risk of intracerebral haemorrhage, particularly for highly complex patients and the use of antiplatelet agents. The risk of bleeding in these patients must be closely monitored.

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Risk Factors for Recovery of Ampicillin-Sulbactam-Resistant Escherichia coli in Hospitalized Patients

Antimicrobial Agents and Chemotherapy ◽

10.1128/aac.44.4.1004-1009.2000 ◽

2000 ◽

Vol 44 (4) ◽

pp. 1004-1009 ◽

Cited By ~ 41

Author(s):

Keith S. Kaye ◽

Anthony D. Harris ◽

Howard Gold ◽

Yehuda Carmeli

Keyword(s):

Risk Factors ◽

Escherichia Coli ◽

Drug Exposure ◽

Multivariate Analyses ◽

Statistical Significance ◽

Hospitalized Patients ◽

E Coli ◽

Factors Associated ◽

Time Period ◽

Independent Risk Factors

ABSTRACT Ampicillin-sulbactam resistance in Escherichia coli is an emerging problem. This study determined risk factors for the recovery of ampicillin-sulbactam-resistant E. coli in hospitalized patients. A case-control design was used to compare two groups of case patients with control patients. The first group of case patients consisted of patients from whom nosocomially acquired ampicillin-sulbactam-resistant E. coli strains were isolated, and the second group of case patients consisted of patients from whom ampicillin-sulbactam-susceptible E. coli strains were isolated. Control patients were a random selection among 5% of all patients admitted during the same time period. Risk factors analyzed included antimicrobial drug exposure, comorbid conditions, and demographics. Univariate and multivariate analyses were performed. Ampicillin-sulbactam-resistant E. coli strains were isolated from 175 patients, and ampicillin-sulbactam-susceptibleE. coli strains were isolated from 577 patients. Nine hundred thirty-four control patients were selected. Exposure to penicillin antibiotics as a class and to ampicillin and ampicillin-sulbactam individually were the only significant, independent risk factors associated with the isolation of ampicillin-sulbactam-resistant E. coli (odds ratio [OR] = 2.32 [P < 0.001], OR = 3.04 [P = 0.02], and OR = 1.72 [P= 0.04], respectively), but they were not associated with the isolation of ampicillin-sulbactam-susceptible E. coli. Interestingly, exposure to piperacillin-tazobactam tended to protect against the isolation of E. coli strains resistant to ampicillin-sulbactam, but this did not reach statistical significance (OR = 0.13; P = 0.11).

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Elevated ESRS, serum FIB, Hcy and stroke history were independent risk factors to PAIS

Pteridines ◽

10.1515/pteridines-2018-0014 ◽

2018 ◽

Vol 29 (1) ◽

pp. 165-171

Author(s):

Tao Zhang ◽

Huiyun Li ◽

Ling Li ◽

Faying Zhou

Keyword(s):

Risk Factors ◽

Ischemic Stroke ◽

Acute Ischemic Stroke ◽

Pearson Correlation ◽

Statistical Significance ◽

Pearson Correlation Test ◽

Independent Risk Factors ◽

Definition Of ◽

Sensitivity Specificity ◽

Medical University

Abstract Background: The aim of this study was to investigate the diagnostic performance of serum homocysteine (Hcy) and Essen stroke risk score (ESRS) in prediction of progressing acute ischemic stroke (PAIS).Methods One hundred and thirty two acute ischemic stroke (AIS) patients were retrospectively recruited from Daping Hospital, Third Military Medical University from February 2016 to January 2018. The 132 AIS patients were divided into PAIS and non-progressing AIS (NPAIS) groups according to the definition of PAIS. The clinical characteristics, serum Hcy concentration, and ESRS were compared between the PAIS and NPAIS groups. The independent risk factors for PAIS were evaluated by logistic regression analysis. The prediction sensitivity, specificity and area under the ROC curve (AUC) of serum Hcy and ESRS for PAIS were calculated using STATA11.0 software.Results: The elevated ESRS (OR=1.82, p<0.05), serum fibrinogen (FIB) (OR=1.18, p<0.05), Hcy (OR=1.21, p<0.05) and personal stroke history (OR=1.74, p<0.05) were independent risk factors for PAIS. The serum Hcy of the PAIS and NPAIS groups were 24.59±9.24 (μmol/L) and 18.20±8.29 (μmol/L) respectively with a statistical significance of p<0.05. The ESRS were 3.43±1.09 and 2.60±0.92 for the PAIS and NPAIS groups respectively, with a significance of p<0.05. The prediction sensitivity, specificity and AUC were 76.24%, 67.74% and 0.73 (95%CI:0.63-0.83), respectively, for serum Hcy. For ESRS, the prediction sensitivity, specificity and AUC were 69.99%, 64.52% and 0.74 (95%CI:0.63-0.84) respectively. Correlation between serum Hcy and ESRS was evaluated by a Pearson correlation test. Significant positive correlation between serum Hcy and ESRS was found in PAIS (r=0.54, p<0.05), and NPAIS patients (r=0.78, p<0.01).Conclusion: Patients with elevated ESRS, serum FIB, Hcy and stroke history had an elevated risk of developing PAIS.

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Risk factors for acute exacerbation of idiopathic interstitial pneumonia in patients undergoing lung cancer treatment

Japanese Journal of Clinical Oncology ◽

10.1093/jjco/hyz115 ◽

2019 ◽

Vol 49 (12) ◽

pp. 1126-1133 ◽

Cited By ~ 2

Author(s):

Tetsuya Taya ◽

Hirofumi Chiba ◽

Gen Yamada ◽

Mamoru Takahashi ◽

Kimiyuki Ikeda ◽

...

Keyword(s):

Risk Factors ◽

Lung Cancer ◽

Cancer Treatment ◽

Interstitial Pneumonia ◽

Chest Ct ◽

Idiopathic Interstitial Pneumonia ◽

Monotherapy Group ◽

Predictive Values ◽

Independent Risk Factors ◽

Clinical Records

Abstract Objective Identifying risk factors for cancer treatment-related acute exacerbations (AEs) of idiopathic interstitial pneumonia (IIP) in patients with lung cancer. Methods We retrospectively reviewed clinical records of 98 patients with concurrent lung cancer and IIPs diagnosed and treated at the Sapporo Medical University Hospital from January 2010 to December 2014. Results Of the 98 patients with concurrent lung cancer and IIPs, 14 patients (14.3%) had AEs. A total of 10 patients died. The univariate analysis revealed that the patients with idiopathic pulmonary fibrosis (IPF) or usual interstitial pneumonia (UIP) patterns on chest computed tomography (CT) had significantly higher rates of AE than those with non-IPF or non-UIP patterns, respectively. Further, those with a reduced percentage of forced vital capacity (%FVC) predictive values or elevated Krebs von den Lungen-6 (KL-6) presented significantly higher rates of AE. Our multivariate analysis identified that UIP pattern on chest CT and each 10% decrease in %FVC were significant independent risk factors for AEs. Of the 14 patients who experienced AEs, 10 cases were associated with cancer treatment. The treatment-specific incidences were 3/40 (7.5%) for surgery, 5/50 (10.0%) for chemotherapy, and 2/26 (7.7%) for radiation therapy. After comparing the AE incidences in 55 cases receiving one treatment (monotherapy group) and in 29 cases receiving two types of treatment or more (multitherapy group), we found no significant differences. Conclusions Chest CT UIP patterns and reduced %FVC are independent risk factors for AE. Moreover, AE incidence did not increase in the multitherapy group compared with the monotherapy group.

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Fatal hemorrhagic pneumonia in patients with hematologic diseases and Stenotrophomonas maltophilia bacteremia: a retrospective study

BMC Infectious Diseases ◽

10.1186/s12879-021-06420-0 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Lixia Zhu ◽

Lulu Wang ◽

Yuping Zhang ◽

Rongrong Chen ◽

Xueying Li ◽

...

Keyword(s):

Risk Factors ◽

Stenotrophomonas Maltophilia ◽

Clinical Characteristics ◽

Clinical Manifestations ◽

Hematologic Diseases ◽

Hemorrhagic Pneumonia ◽

Independent Risk Factors ◽

High Level ◽

Clinical Records ◽

Overall Mortality

Abstract Background Fatal hemorrhagic pneumonia is one of the most severe manifestations of Stenotrophomonas maltophilia (SM) infections. Here, we aimed to investigate the clinical characteristics of SM bacteremia and to identify the risk factors of hemorrhagic pneumonia caused by SM in patients with hematologic diseases. Methods The clinical records of 55 patients diagnosed with hematologic diseases and SM bacteremia were retrospectively reviewed. We compared patients’ clinical characteristics and outcomes between the hemorrhagic pneumonia group and non-hemorrhagic pneumonia group. Results Twenty-seven (49.1%) patients developed hemorrhagic pneumonia. The overall mortality rate of SM bacteremia was 67.3%. Hemorrhagic pneumonia (adjusted HR 2.316, 95% CI 1.140–4.705; P = 0.020) was an independent risk factor of 30-day mortality in hematological patients with SM bacteremia. Compared with the non-hemorrhagic pneumonia group, patients in the hemorrhagic pneumonia group were older and showed clinical manifestations as higher proportions of isolated SM in sputum culture, neutropenia and elevated procalcitonin (PCT). Multivariate analysis showed that neutropenia, high levels of PCT, prior tigecycline therapy within 1 month were independent risk factors associated with hemorrhagic pneumonia. Conclusions Neutropenia, high level of PCT and prior tigecycline therapy within 1 month were significant independent predictors of hemorrhagic pneumonia in hematologic patients with SM bacteremia. Due to no effective antibiotics to prevent hemorrhagic pneumonia, prophylaxis of SM infection and its progression to hemorrhagic pneumonia is particularly important.

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Comparison of posterior capsule folds following intracapsular implantation of three types of intraocular lenses with different haptic design

International Eye Research ◽

10.18240/ier.2020.02.03 ◽

2020 ◽

Vol 1 (2) ◽

pp. 78-82

Author(s):

Ling-Lin Zhang ◽

◽

Xiao-Jun Cai ◽

Keyword(s):

Risk Factors ◽

Regression Analysis ◽

Intraocular Lenses ◽

Risk Indicators ◽

Posterior Capsule ◽

Slit Lamp ◽

Iol Implantation ◽

Logistics Regression ◽

Different Types ◽

Independent Risk Factors

AIM: To compare the incidence of posterior capsule folds among different types of intraocular lens (IOL) to determine risk factors of posterior capsule folds. METHODS: It was a retrospective study. We collected the cases in which the patients underwent phacoemulsification (PHACO) and IOL implantation and at least one of the three types of IOL was implanted, including 2-haptic 3-piece IOLs (HOYA PY60AD), 4-haptic 1-piece IOLs (Bausch&Lomb AO), 2-haptic 1-piece IOLs (AMO Tecnis ZCB00). The posterior capsule folds were measured using slit lamp microscope 2d after the surgery. Information of patient’s age, gender, length of ocular axis, intraocular pressure, types of IOL were recorded. Posterior capsule fold risk indicators were identified by using logistic regression analysis. RESULTS: One hundred eighty-seven patients (242 eyes) had been collected, including 80 eyes implanted with HOYA PY60AD IOLs, 81 eyes implanted with Bausch&Lomb AO IOLs, 81 eyes implanted with AMO Tecnis ZCB00 IOLs. The incidence of posterior capsule folds of patients implanted with HOYA PY60AD IOLs was significantly higher than those of patients implanted with AMO Tecnis ZCB00 IOLs. While the incidence of patients implanted with Bausch&Lomb AO IOLs was significantly lower than those of patients implanted with AMO Tecnis ZCB00 IOLs. Multi-factor logistics regression analysis demonstrated that independent risk factors were type of IOLs and length of ocular axis. Compared with AMO Tecnis ZCB00 IOLs, using HOYA PY60AD IOLs increased the risk of posterior capsule folds [P=0.020, OR (95%CI)=2.145 (1.129, 4.073)], while using Bausch&Lomb AO IOLs reduced the risk [P=0.001, OR (95%CI)=0.274 (0.127, 0.591)]. Shorter ocular axis might increase the risk of posterior capsule folds [P=0.012, OR (95%CI)=0.669 (0.489, 0.915)]. CONCLUSION: Haptic design should be an important consideration in IOL design. Compared with AMO Tecnis ZCB00 IOLs, using HOYA PY60AD IOLs is more likely to lead to posterior capsule folds formation, while using Bausch&Lomb AO IOLs is less likely to lead the formation. The posterior capsule folds are more engendered in eyes with shorter ocular axis.

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Anatomical Distribution of First VTE Event and Risk of VTE Recurrence: Long Term Follow-up and Retrospective Analysis of 346 Patients. Experience From a Single Center

Blood ◽

10.1182/blood.v118.21.1224.1224 ◽

2011 ◽

Vol 118 (21) ◽

pp. 1224-1224

Author(s):

Emmanouil Papadakis ◽

Dionysia Theocharidou ◽

Anastasia Mpanti ◽

Anastasia Spyrou ◽

Konstantinos Loukidis ◽

...

Keyword(s):

Risk Factors ◽

Statistical Analysis ◽

High Risk ◽

Conflicts Of Interest ◽

Statistical Significance ◽

Recurrence Risk ◽

Published Data ◽

Anatomical Distribution ◽

Independent Risk Factors

Abstract Abstract 1224 Venous thromboembolism (VTE) is a chronic disease with recurrence risk that persists over the years. Predicting the chance of recurrence on an individual basis is of paramount importance for the appropriate tailoring of anticoagulant therapy. Recurrence risk is affected by thrombophilia and is lower in patients with provoked VTE than in patients with unprovoked thrombosis. Up to date there are no studies focused on the recurrence risk according to the anatomical distribution of the 1st VTE event. In order to evaluate the risk factors of VTE recurrence, after a review of relevant literature we set specific laboratory and clinical variables, which could be associated with VTE recurrence. Moreover, we evaluated retrospectively 346 patients of the Haemostasis Unit, who had already had an episode of VTE concerning the risk of VTE recurrence. Data statistical analysis was done with SPSS package 15.0. At first a monovariable statistical model was used with significance levels set at p= 0.05. For the multivariable statistical analysis model we used all variables with p< 0.1 from the previous model and those mentioned at recent medical literature as significantly related with VTE recurrence. The 346 patients enrolled had already suffered a first episode of VTE and are being followed up regarding VTE recurrence. The study population, 169 (48.7%) male and 178 (51.3%) female, had a mean age at first VTE of 41.54 years. The exclusion criteria of our study were: high risk patients for VTE recurrence who received indefinite anticoagulation (n=72), patients who have suffered VTE and had a follow up period after discontinuation of anticoagulation shorter than 2 years (n=73) and patients who were lost at follow up (n=15). Among 194 patients who were enrolled 108 (55.7%) were women and 86 (44.3%) men, with a mean age at 1st VTE of 40.10 years. 114 patients had only one VTE episode, 59 suffered two, 16 patients had tree episodes and 5 patients had >= 4 episodes. Based on previously published data we tried to define whether the following variables are high risk factors for VTE recurrence in our population: gender, age of diagnosis, thrombophilic factors (FVLeiden, FII, HCY, VIII, AT, PrC, PrS, PAI1, Lp(a), XII), the presence of unprovoked VTE episode and VTE location (DVT, PE, CNS Thrombosis). Male gender p=0,038, FVLeiden homozygous p=0.036, the presence of unprovoked VTE p=0.029, and VTE location p= 0.05 reached statistical significance on a monovariable analysis. Based on the previous analysis and on previously published data we applied gender, age at the time of diagnosis, presence of unprovoked VTE episode and VTE location on a multiple regression analysis in order to define independent risk factors concerning VTE recurrence (Table 1).Table 1Independent Risk factors concerning VTE recurrenceRisk FactorORCI 95%FVLeiden9.7931.07–89.62Unprovoked VTE9.7571.404–5.414Pulmonary embolism11.5321.419–93.746Deep Venus Thrombosis (DVT)17.7932.232–141.841 Concerning VTE location, CNS thrombosis has the lowest risk for VTE recurrence and Pulmonary embolism and DVT are independent risk factors compared to the first one. Among VTE events CNS thrombosis and DVT/PE share similarities regarding the transient risk factors and the presence of predisposing thrombophilias. As far as the recurrence risk after a first VTE our study demonstrates ( in agreement with current literature) that CNS thrombosis carries recurrence risk statistically lesser than PE and the highest recurrence risk carry the patients after a first DVT event. Our study is the first observational study regarding recurrence risk after VTE coming from Greece. Disclosures: No relevant conflicts of interest to declare.

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