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Nils Kucher, Victor F. Tapson, Samuel Z. Goldhaber
Risk factors associated with symptomatic pulmonary embolism in a large cohort of deep vein thrombosis patients
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 (63.715.6 years; 49% men) and DVT patients (63.417.3 years; 46% men). Body mass index (BMI) was higher in patients with DVT plus PE (median 29.0, range 15.467.0 kg/m2) than in patients with DVT (median 26.8, range 9.764.4 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 1.392.43), prior PE (OR 1.68, 95% CI 1.202.35),obesity (BMI >30 kg/m2) (OR 1.65, 95% CI 1.332.04), chronic lung disease (OR 1.51, 95%CI 1.132.01), as well as omission of prophylaxis (OR 1.30, 95%CI 1.041.64) emerged as independent predictors of concomitant symptomatic PE.
Thrombosis and Haemostasis, Schattauer
Print ISSN: 0340-6245
Volume: 93, 03/2005
Pages: 494 - 498