Risk factors for deep vein thrombosis and pulmonary embolism -: A population-based case-control study
Risk factors for deep vein thrombosis and pulmonary embolism -: A population-based case-control study
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DOI：
10.1001/archinte.160.6.809
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发表时间：
2000-03-27
影响因子：
--
通讯作者：
Melton, LJ
中科院分区：
文献类型：
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作者：
Heit, JA;Silverstein, MD;Melton, LJ
背景：报道的静脉血栓栓塞（VTE）危险因素差异很大，每个因素的大小和独立性都不确定。目的：确定深静脉血栓形成和肺栓塞的独立危险因素，并估计每种风险的大小。患者和方法：我们对625名明尼苏达州奥姆斯特德县的患者进行了一项基于人群的、嵌套的病例对照研究，这些患者在1976年1月1日至1990年12月31日的15年间被诊断为首次静脉血栓栓塞的患者，以及625名奥姆斯特德县没有静脉血栓栓塞的患者。两组在年龄、性别、日历年和病历号上匹配。结果：静脉血栓形成的独立危险因素包括手术（优势比[OR]， 21.7； 95%可信区间[CI]， 9.4-49.9）、创伤（OR, 12.7; 95% CI, 4.1-39.7）、住院或养老院禁闭（OR, 8.0; 95% CI, 4.5-14.2）、恶性肿瘤伴化疗（OR, 6.5; 95% CI, 2.1-20.2）或不伴化疗（OR, 4.1;95% CI, 1.9-8.5）、中心静脉导管或起搏器（OR, 5.6, 95% CI, 1.6-19.6）、浅静脉血栓形成(OR, 4.3；95% CI, 1.8-10.6)和神经系统疾病伴四肢麻痹（OR, 3.0; 95% CI, 1.3-7.4）。与静脉曲张相关的风险随着年龄的增长而降低（45岁：OR， 4.2; 95% CI, 1.6-11.3； 60岁：OR， 1.9; 95% CI, 1.0-3.6； 75岁：OR， 0.9; 95% CI, 0.6-1.4），而肝脏疾病患者的风险降低（OR, 0.1; 95% CI, 0.0-0.7）。结论：住院或养老院坐月子、手术、外伤、恶性肿瘤、化疗、神经系统疾病伴瘫、中心静脉导管或起搏器、静脉曲张、浅静脉血栓形成是静脉血栓形成的独立且重要的危险因素。
Background: Reported risk factors for venous thromboembolism (VTE) vary widely, and the magnitude and independence of each are uncertain.Objectives: To identified independent risk factors for deep vein thrombosis and pulmonary embolism and to estimate the magnitude of risk for each.Patients and Methods: We performed a population based, nested, case-control study of 625 Olmsted County, Minnesota, patients with a first lifetime VTE diagnosed during the 15-year period from January 1, 1976, through December 31, 1990, and 625 Olmsted County patients without VTE. The 2 groups were matched on age, sex, calendar year, and medical record number.Results: Independent risk factors for VTE included surgery (odds ratio [OR], 21.7; 95% confidence interval [CI], 9.4-49.9), trauma (OR, 12.7; 95% CI, 4.1-39.7), hospital or nursing home confinement (OR, 8.0; 95% CI, 4.5-14.2), malignant neoplasm with (OR, 6.5; 95% CI, 2.1-20.2) or without (OR, 4.1;95% CI, 1.9-8.5) chemotherapy, central venous catheter or pacemaker (OR, 5.6, 95% CI, 1.6-19.6), superficial vein thrombosis (OR, 4.3; 95% CI, 1.8-10.6), and neurological disease with extremity paresis (OR, 3.0; 95% CI, 1.3-7.4). The risk associated with varicose veins diminished with age (for age 45 years: OR, 4.2; 95% CI, 1.6-11.3, for age 60 years: OR, 1.9; 95% CI, 1.0-3.6; for age 75 years: OR, 0.9; 95% CI, 0.6-1.4),while patients with liver disease had a reduced risk (OR, 0.1; 95% CI, 0.0-0.7).Conclusion: Hospital or nursing home confinement, surgery, trauma, malignant neoplasm, chemotherapy, neurologic disease with paresis, central venous catheter or pacemaker, varicose veins, and superficial vein thrombosis are independent and important risk factors for VTE.