The contribution of immobility risk factors to the incidence of venous thrombosis in an older population.
J Thromb Haemost. 2013 Dec 11;
Authors: Engbers MJ, Blom JW, Cushman M, Rosendaal FR, van Hylckama Vlieg A
BACKGROUND: Venous thrombosis is common in the older population. Assessment of risk factors is necessary in order to implement preventive measures.
OBJECTIVES: We studied the associations between immobility-related risk factors and thrombosis, specifically, hospitalisation, surgery, fractures, plaster cast use, minor injuries, and transient immobility at home in an older population.
METHODS: Analyses were performed in the Age and Thrombosis, Acquired and Genetic risk factors in the Elderly (AT-AGE) study, a two-center population-based case-control study. Consecutive cases aged > 70 years with a first-time thrombosis (n= 401) and control subjects > 70 years old without a history of thrombosis were included (n= 431). Exclusion criteria were active malignancy and severe cognitive disorders. We calculated odds ratios (OR) with 95% confidence intervals (CI95) after adjustment for age, sex, body mass index and study center, and population attributable risks (PAR).
RESULTS: There was a 15-fold (OR 14.8; CI95 4.4-50.4) increased risk of thrombosis within two weeks after hospital discharge. Surgery (OR 6.6; CI95 3.7-11.6), fractures (OR 12.7; CI95 3.7-43.7), plaster cast (OR 6.2; CI95 2.0-18.9), minor leg injuries (OR 1.9; CI95 1.1-3.3), and transient immobility at home (OR 5.0; CI95 2.3-11.2) were all associated with thrombosis risk over three months. The PAR for in-hospital immobility was 27%, and for out-of-hospital immobility 15%.
CONCLUSIONS: In those over 70 years of age, in-hospital and out-of hospital immobility are strong risk factors for thrombosis. Additional studies on preventive measures during immobilisation in this age group should not focus solely on hospital settings. This article is protected by copyright. All rights reserved.
PMID: 24330554 [PubMed - as supplied by publisher]