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

Nils Kucher; Victor F. Tapson; Samuel Z. Goldhaber; for the DVT FREE Steering Committee

doi:10.1160/TH04-09-0587

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 2005; 93(03): 494-498
DOI: 10.1160/TH04-09-0587

Blood Coagulation, Fibrinolysis and Cellular Haemostasis

Schattauer GmbH

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

Nils Kucher

¹Department of Medicine, Cardiovascular Division, Brigham and Women’s Hospital, Boston, Massachusetts, USA

,

Victor F. Tapson

²Department of Medicine, Duke University Medical Center, Durham, North Carolina, USA

,

Samuel Z. Goldhaber

¹Department of Medicine, Cardiovascular Division, Brigham and Women’s Hospital, Boston, Massachusetts, USA

,

for the DVT FREE Steering Committee

› Author Affiliations

Abstract

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/m²) (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.

Keywords

Deep vein thrombosis - pulmonary embolism - venous thromboembolism

Full Text

References

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