Acute infections and venous thromboembolism.
J Intern Med. 2011 Oct 25;
Authors: Schmidt M, Horvath-Puho E, Thomsen RW, Smeeth L, Toft Sørensen H
Abstract
Objective:? The aim of the study was to examine whether various hospital-diagnosed infections or infections treated in the community are associated with an increased risk of venous thromboembolism (VTE). Design and subjects:? We conducted this population-based case-control study in Northern Denmark (population 1.8 million) using medical databases. We identified all patients with a first hospital diagnosed VTE during the period 1999-2009 (n=15,009). For each case, we selected 10 controls from the general population matched on age, gender and county of residence (n=150,074). We identified all hospital-diagnosed infections and community prescriptions for antibiotics one year predating VTE. We used odds ratios from a conditional logistic regression model to estimate incidence rate ratios (IRRs) of VTE within different time intervals of the first year after infection, controlling for confounding. Results:? Respiratory tract, urinary tract, skin, intra-abdominal and bacteraemic infections diagnosed in hospital or treated in the community were associated with a >2-fold increased VTE risk. The association was strongest within the first 2 weeks after infection onset, gradually declining thereafter. Compared with individuals without infection during the year before VTE, the IRR for VTE within the first 3 months after infection was 12.5 (95% confidence interval (CI): 11.3-13.9) for patients with hospital-diagnosed infection and 4.0 (95% CI: 3.8-4.1) for patients treated with antibiotics in the community. Adjustment for VTE risk factors reduced these IRRs to 3.3 (95% CI: 2.9-3.8) and 2.6 (95% CI: 2.5-2.8), respectively. Similar associations were found for unprovoked VTE, and for deep venous thrombosis and pulmonary embolism individually. Conclusions:? Infections are a risk factor for VTE.
PMID: 22026462 [PubMed - as supplied by publisher]