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Hospitalization with infection and incident venous thromboembolism: The ARIC study.

TitleHospitalization with infection and incident venous thromboembolism: The ARIC study.
Publication TypeJournal Article
Year of Publication2017
AuthorsCowan LT, Lutsey PL, Pankow JS, Cushman M
Secondary AuthorsFolsom AR
JournalThromb Res
Date Published2017 Mar
KeywordsAged, Cross-Over Studies, Female, Hospitalization, Humans, Incidence, Infections, Logistic Models, Male, Middle Aged, Prospective Studies, Risk Factors, Venous Thromboembolism

BACKGROUND AND OBJECTIVES: Acute triggers for VTE, which may include infection, are understudied, as is the timing and duration of VTE risk after infection. We hypothesized that there is an association between hospitalization with infection and short-term VTE risk that exceeds the known association between hospitalization and VTE.

METHODS: VTE cases and infections were identified in the Atherosclerosis Risk in Communities (ARIC) cohort. A case-crossover design and conditional logistic regression were used to compare hospitalized infections among VTE cases (14, 30, 42, and 90days before VTE) with corresponding control periods 1year and 2years prior. Since hospitalization is a known VTE trigger, study design and analytical techniques were used to isolate the impact of infection.

RESULTS: There were 845 adjudicated incident VTE cases. Hospitalization with infection was more common in all case periods compared to equivalent control periods: 14day OR (95% CI)=1.7 (0.5, 5.8), 30day OR (95% CI)=2.7 (1.1, 6.4), 42day OR (95% CI)=2.2 (1.1, 4.7), and 90day OR (95% CI)=1.2 (0.7, 2.0). The association was generally strongest in exposure periods closest to the VTE event and decreased as the time window before VTE increased.

CONCLUSIONS: These results support the hypothesis that hospitalized infection is a trigger of VTE. VTE preventive measures may prevent VTE events if used in the peri-infection period but clinical trials are needed.

Alternate JournalThromb Res
PubMed ID28161616
PubMed Central IDPMC5416934
Grant ListR01 HL059367 / HL / NHLBI NIH HHS / United States
T32 HL007779 / HL / NHLBI NIH HHS / United States