Increased risk of venous thromboembolism within the first year after Staphylococcus aureus bacteraemia: a nationwide observational matched cohort study.
J Intern Med. 2013 Oct 12;
Authors: Mejer N, Westh H, Schønheyder HC, Jensen AG, Larsen AR, Skov R, Benfield T, The Danish Staphylococcal Bacteraemia Study Group
Abstract
OBJECTIVES: Recent evidence suggests that there is an association between infection and venous thromboembolism (VTE). Here we examined the risk of VTE after Staphylococcus aureus bacteraemia (SAB) compared to the risk in control subjects.
DESIGN AND SETTING: Register-based nationwide observational cohort study of hospitalized patients and matched control subjects from the general population in Denmark between 1995 and 2008.
RESULTS: Among 15 669 SAB cases and 156 690 controls, 182 and 511, respectively, experienced VTE within 1 year. The overall incidence rate (IR) of VTE among cases was highest within the first 30 days [IR of deep vein thrombosis (DVT), 39.3 (95% confidence interval (CI) 28.9-53.4)/1000 person-years (PYs); IR of pulmonary embolism (PE), 16.3 (95% CI 10.1-26.2)/1000 PYs]. IRs of DVT were particularly increased among cases with a previous diagnosis of VTE, community-acquired infection, a history of injection drug use and in younger age groups. The overall hazard ratio of VTE for cases compared to controls declined from 15.6 (95% CI 10.3-23.5) in the first 30 days after SAB to 4.5 (95% CI 3.2-6.2) from 181-365 days after infection. The increased risk of VTE among SAB patients persisted after excluding cases with identified VTE risk factors.
CONCLUSIONS: There was a particularly high risk of VTE during the first month following an episode of SAB. The risk declined over time but remained at a three-fold increased level compared to control subjects, suggesting that there are shared risk factors for SAB and VTE. Patients with SAB and well-documented risk factors for VTE may benefit from thromboprophylaxis. This article is protected by copyright. All rights reserved.
PMID: 24118528 [PubMed - as supplied by publisher]