RT Journal Article
T1 Risk Factors and Short-term Mortality of Venous Thromboembolism Diagnosed in the Primary Care Setting in the United Kingdom
A1 Huerta Álvarez, María Consuelo Yolanda
A1 Johansson, Saga
A1 Wallander, Mari-Ann
A1 García Rodríguez, Luis A.
AB Antecedentes  El tromboembolismo venonos (TEV), que se manifiesta como trombosis venosa profunda (TVP) y embolia pulmonar (EP), sigue siendo una enfermedad vascular común con alta mortalidad y morbilidad. Nuestro objetivo fue estudiar el espectro clínico de la TEV, evaluar su incidencia en la población general y evaluar los posibles factores de riesgo.Métodos  Estudio prospectivo de cohortes con análisis de casos y controles anidados utilizando la Base de Datos de Investigación de Medicina General (CPRD) inglesa (1994-2000). Se diagnosticó TEV por primera vez en 6550 pacientes. Los casos se compararon con una muestra aleatoria de 10 000 controles y se emparejaron por frecuencia según la edad, el sexo y el año.Resultados  La tasa de incidencia de TEV fue de 74,5 por cada 100 000 personas-año. El sobrepeso, las varices, la enfermedad inflamatoria intestinal, el cáncer y el uso de corticosteroides orales se asociaron con un mayor riesgo de TEV. La cardiopatía isquémica, la insuficiencia cardíaca y las enfermedades cerebrovasculares se asociaron con un mayor riesgo de EP, pero no con TVP. La tromboembolia venosa se asoció fuertemente con fracturas (odds ratio [OR], 21,3; intervalo de confianza [IC] del 95 %, 15,7-28,9) y cirugía (OR, 25,0; IC del 95 %, 14,4-43,5). En las mujeres, el riesgo de TEV fue de 1,9 (IC del 95 %, 1,5-2,3) entre las que recibían terapia hormonal y de 1,9 (IC del 95 %, 1,4-2,5) entre las que tomaban anticonceptivos orales. El cáncer y las enfermedades cerebrovasculares presentaron un mayor riesgo de EP mortal en comparación con la EP no mortal.
AB Background  Venous thromboembolism (VTE) manifesting as deep vein thrombosis (DVT) and pulmonary embolism (PE) remains a common vascular disease with high mortality and morbidity. Our aim was to study the clinical spectrum of VTE, assess its incidence in the general population, and evaluate potential risk factors.Methods  Prospective cohort study with nested case-control analysis using the General Practice Research Database (1994-2000). Venous thromboembolism was newly diagnosed in 6550 patients. Cases were compared with a random sample of 10 000 controls and frequency-matched by age, sex, and year.Results  The incidence rate of VTE was 74.5 per 100 000 person-years. Overweight, varicose veins, inflammatory bowel disease, cancer, and oral corticosteroid use were associated with a greater risk of VTE. Ischemic heart disease, heart failure, and cerebrovascular diseases were associated with an increased risk of PE but not with DVT. Venous thromboembolism was strongly associated with fractures (odds ratio [OR], 21.3; 95% confidence interval [CI], 15.7-28.9) and surgery (OR, 25.0; 95% CI, 14.4-43.5). In women, the risk of VTE was 1.9 (95% CI, 1.5-2.3) among those receiving opposed hormone therapy (in which the woman takes estrogen throughout the month and progesterone for 10-14 days later in the month) and 1.9 (95% CI, 1.4-2.5) among those taking oral contraceptives. Cancer and cerebrovascular diseases presented a greater relative risk of fatal PE compared with nonfatal PE.Conclusions  Overweight, varicose veins, cancer, inflammatory bowel disease, fractures, surgery, and use of oral corticosteroids, oral contraceptives, and opposed hormone therapy were independent risk factors for both DVT and PE. The magnitude of the association with some risk factors varied between DVT and PE, as well as between fatal and nonfatal PE.
PB American Medical Association
SN 0003-9926
YR 2007
FD 2007-05-14
LK https://hdl.handle.net/20.500.14352/132033
UL https://hdl.handle.net/20.500.14352/132033
LA eng
NO Huerta C, Johansson S, Wallander M, García Rodríguez LA. Risk Factors and Short-term Mortality of Venous Thromboembolism Diagnosed in the Primary Care Setting in the United Kingdom. Arch Intern Med. 2007;167(9):935–943. doi:10.1001/archinte.167.9.935
DS Docta Complutense
RD 18 mar 2026