System Maintenance Notice

Please note that maintenance work is scheduled between 4 AM and 5 AM - CET. During this time, you may experience reduced performance. Thanks for your patience.

Publications

Journal Article Observational Study Research Support, N.I.H., Extramural Ppublish 38 citations

PubMed: 35426248 DOI: 10.1111/jth.15729

Venous thrombosis risk during and after medical and surgical hospitalizations: The medical inpatient thrombosis and hemostasis (MITH) study.

J Thromb Haemost 20(7):1645-1652

Authors: Ximena Jordan Bruno, Insu Koh, Pamela L Lutsey, Robert F Walker, Nicholas S Roetker, Katherine Wilkinson, Nicolas L Smith, Timothy B Plante, Allen B Repp, Chris E Holmes, Mary Cushman, Neil A Zakai

Affiliations

  • Hematology Oncology Division, Department of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
  • Department of Medicine, Larner College of Medicine, University of Vermont, Burlington, Vermont, USA.
  • University of Vermont Medical Center, Burlington, Vermont, USA.
  • Department of Pathology & Laboratory Medicine, Larner College of Medicine, University of Vermont, Burlington, Vermont, USA.
  • Division of Epidemiology & Community Health, University of Minnesota, Minneapolis, Minnesota, USA.
  • Chronic Disease Research Group, Hennepin Healthcare Research Institute, Minneapolis, Minnesota, USA.
  • Department of Epidemiology, University of Washington, Seattle, Washington, USA. Kaiser Permanente Washington, Kaiser Permanente Washington Health Research Institute, Seattle, Washington, USA. Department of Veterans Affairs Office of Research and Development, Seattle Epidemiologic Research and Information Center, Seattle, Washington, USA.

Abstract

BACKGROUND

Thirty to seventy percent of all venous thromboembolism (VTE) events are associated with hospitalization. The absolute and relative risks during and after hospitalization are poorly characterized.

OBJECTIVES

Quantify the absolute rate and relative risk of VTE during and up to 3 months after medical and surgical hospitalizations.

PATIENTS/METHODS

We conducted an observational cohort study between 2010 and 2016 of patients cared for by the University of Vermont (UVM) Health Network's primary care population. Cox proportional hazard models with hospitalization modeled as a time-varying covariate were used to estimate VTE risk.

RESULTS

Over 4.3 years of follow-up, 55 220 hospitalizations (156 per 1000 person-years) and 713 first venous thromboembolism events (2.0 per 1000 person-years) occurred. Among individuals not recently hospitalized, the rate of venous thromboembolism was 1.4 per 1000 person-years and 71.8 per 1000 person-years during hospitalization. During the first, second, and third months after discharge, the rates of venous thromboembolism were 35.1, 11.3, and 5.2 per 1000 person-years, respectively. Relative to those not recently hospitalized, the age- and sex-adjusted HRs of venous thromboembolism were 38.0 (95% CI 28.0, 51.5) during hospitalization, and 18.4 (95% CI 15.0, 22.6), 6.3 (95% CI 4.3, 9.0), and 3.0 (95% CI 1.7, 5.4) during the first, second, and third months after discharge, respectively. Stratified by medical versus surgical services the rates were similar.

CONCLUSION

Hospitalization and up to 3 months after discharge were strongly associated with increased venous thromboembolism risk. These data quantify this risk for use in future studies.

MeSH

Epidemiology, Thromboembolism, Hospitalization, Venous Thrombosis, Cohort Studies, Patient Discharge, Venous Thromboembolism, Thrombosis, Hemostasis

Cited by