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Risk factors associated with symptomatic pulmonary embolism in a large cohort of deep vein thrombosis patients

Journal: Thrombosis and Haemostasis
ISSN: 0340-6245
DOI: http://dx.doi.org/10.1160/TH04-09-0587
Issue: 2005: 93/3 (Mar) pp. 399-623
Pages: 494-498
Ahead of Print: ###MANUSCRIPT_aheadofprint###

Risk factors associated with symptomatic pulmonary embolism in a large cohort of deep vein thrombosis patients

Nils Kucher(1) , Victor F. Tapson(2) , Samuel Z. Goldhaber (1) for the DVT FREE Steering Committee
(1)Department of Medicine, Cardiovascular Division, Brigham and Women’s Hospital, Boston, Massachusetts, USA (2)Department of Medicine, Duke University Medical Center, Durham, North Carolina, USA

Summary

In patients with deep vein thrombosis (DVT), the factors which predispose to concomitant symptomatic pulmonary embolism (PE) have remained uncertain. From a prospective cohort of 5,451 consecutive patients with ultrasound-confirmed DVT, we analyzed 4,211 patients with a known status for presence (n =639) or absence (n = 3572) of symptomatic PE.Age and gender were similar in DVT plus PE (63.7±15.6 years; 49% men) and DVT patients (63.4± 17.3 years; 46% men). Body mass index (BMI) was higher in patients with DVT plus PE (median 29.0, range 15.4–67.0 kg/m2 ) than in patients with DVT (median 26.8, range 9.7–64.4 kg/m2 ; p <0.001). Chronic lung disease (17% vs. 12%; p <0.001), a personal history of PE (11% vs. 6%; p <0.001), and a family history of DVT or PE (8% vs. 4%; p <0.001) were more frequent in DVT plus PE patients.Twenty-seven percent of DVT plus PE patients received prophylaxis prior to the thromboembolic event compared with 32% of DVT patients (p=0.002). Proximal DVT (OR 1.84, 95% CI 1.39–2.43), prior PE (OR 1.68,95% CI 1.20–2.35),obesity (BMI >30 kg/m 2 ) (OR 1.65, 95% CI 1.33–2.04), chronic lung disease (OR 1.51, 95%CI 1.13–2.01), as well as omission of prophylaxis (OR 1.30, 95%CI 1.04–1.64) emerged as independent predictors of concomitant symptomatic PE.