Recent respiratory infection and risk of venous thromboembolism: case-control study through a general practice database
Recent respiratory infection and risk of venous thromboembolism: case-control study through a general practice database
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DOI：
10.1093/ije/dyr012
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发表时间：
2011-06-01
影响因子：
7.7
通讯作者：
Meade, Tom W.
中科院分区：
文献类型：
--
作者：
Clayton, Tim C.;Gaskin, Marion;Meade, Tom W.
背景：呼吸道感染与心脏病发作和中风风险之间的关系已得到充分证实。然而，很少有证据表明呼吸道感染和静脉血栓栓塞（VTE）之间存在关联。在这篇文章中，我们描述了呼吸道感染和静脉血栓栓塞之间的关系。方法对所有年龄在18岁以上首次诊断为深静脉血栓形成（DVT）或肺栓塞（PE）的病例进行分析，并从初级保健全科医生数据库中选取单一匹配的对照。除了匹配特征外，还收集了其他潜在重要混杂因素的信息。结果指标日前一年DVT呼吸道感染病例457/11 557例（4.0%），前一个月73例，对照组262/11 557例（2.3%），前一个月24例。感染后一个月内发生DVT的风险增加[校正优势比(OR) = 2.64, 95%可信区间（95% CI） 1.62-4.29]，持续时间长达一年。为避免早期PE的误诊，在指标日期前1年内有180/5162例（3.5%）PE伴呼吸道感染，对照组为94/5162例（1.8%）。感染后3个月发生PE的风险增加（调整后OR = 2.50, 95% CI 1.33-4.72），可能持续1年。结论近期呼吸道感染与静脉血栓栓塞有很强的相关性。在决定预防或流产感染时，应减少静脉和动脉事件的区别，特别是在高危患者中。
Background The association between respiratory infection and risk of heart attacks and strokes is well established. However, less evidence exists for an association between respiratory infection and venous thromboembolism (VTE). In this article, we describe the associations between respiratory infection and VTE.Methods All cases aged epsilon 18 years of first-time diagnosis of deep-vein thrombosis (DVT) or pulmonary embolism (PE) were identified together with single-matched controls from a primary care general practice database. In addition to the matching characteristics, information was collected on other potentially important confounding factors.Results There were 457/11 557 (4.0%) DVT cases with respiratory infection in the year before the index date (73 in the preceding month) compared with 262/11 557 (2.3%) controls (24 in the preceding month). There was an increased risk of DVT in the month following infection [adjusted odds ratio (OR) = 2.64, 95% confidence interval (95% CI) 1.62-4.29] which persisted up to a year. There were 180/5162 (3.5%) PE cases with respiratory infection in the year before the index date compared with 94/5162 (1.8%) controls excluding those in the preceding month to avoid the possible misdiagnosis of early PE. There was an increased risk of PE in the 3 months following infection (adjusted OR = 2.50, 95% CI 1.33-4.72) which may have persisted up to a year.Conclusions There are strong associations between recent respiratory infection and VTE. There should be less distinction between venous and arterial events in decisions about preventing or aborting infections, especially in high-risk patients.