Surgery as a trigger for incident venous thromboembolism: results from a population-based case-crossover study
Background: Surgery is a major transient risk factor for venous thromboembolism (VTE). However, the impact of major surgery as a VTE trigger has been scarcely investigated using a case-crossover design. Aim: To investigate the role of major surgery as a trigger for incident VTE in a population-based...
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ftdoajarticles:oai:doaj.org/article:0579b6c97b8a460da83e4c618fa9e3f7 2023-09-26T15:23:49+02:00 Surgery as a trigger for incident venous thromboembolism: results from a population-based case-crossover study Dana Meknas Sigrid Kufaas Brækkan John-Bjarne Hansen Vania Maris Morelli https://doi.org/10.1055/a-2159-9957 https://doaj.org/article/0579b6c97b8a460da83e4c618fa9e3f7 EN eng Georg Thieme Verlag KG http://www.thieme-connect.de/DOI/DOI?10.1055/a-2159-9957 https://doaj.org/toc/2512-9465 2512-9465 doi:10.1055/a-2159-9957 https://doaj.org/article/0579b6c97b8a460da83e4c618fa9e3f7 TH Open, Vol , Iss Diseases of the circulatory (Cardiovascular) system RC666-701 article ftdoajarticles https://doi.org/10.1055/a-2159-9957 2023-08-27T00:36:39Z Background: Surgery is a major transient risk factor for venous thromboembolism (VTE). However, the impact of major surgery as a VTE trigger has been scarcely investigated using a case-crossover design. Aim: To investigate the role of major surgery as a trigger for incident VTE in a population-based case-crossover study while adjusting for other concomitant VTE triggers. Methods: We conducted a case-crossover study with 531 cancer-free VTE cases derived from the Tromsø Study cohort. Triggers were registered during the 90 days before a VTE event (hazard period) and in four preceding 90-day control periods. Conditional logistic regression was used to estimate odds ratios (ORs) with 95% confidence intervals (CIs) for VTE according to major surgery and after adjustment for other VTE triggers. Results: Surgery was registered in 85 of the 531 (16.0%) hazard periods and in 38 of the 2124 (1.8%) control periods, yielding an OR for VTE of 11.40 (95% CI 7.42-17.51). The OR decreased to 4.10 (95% CI 2.40-6.94) after adjustment for immobilization and infection and was further attenuated to 3.31 (95% CI 1.83-5.96) when additionally adjusted for trauma, blood transfusion and central venous catheter. In a mediation analysis, 51.4% (95% CI 35.5%-79.7%) of the effect of surgery on VTE risk could be mediated through immobilization and infection. Conclusions: Major surgery was a trigger for VTE, but the association between surgery and VTE risk was in part explained by other VTE triggers often coexisting with surgery, particularly immobilization and infection. Article in Journal/Newspaper Tromsø Directory of Open Access Journals: DOAJ Articles Tromsø TH Open 07 03 e244 e250 |
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Open Polar |
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Directory of Open Access Journals: DOAJ Articles |
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English |
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Diseases of the circulatory (Cardiovascular) system RC666-701 |
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Diseases of the circulatory (Cardiovascular) system RC666-701 Dana Meknas Sigrid Kufaas Brækkan John-Bjarne Hansen Vania Maris Morelli Surgery as a trigger for incident venous thromboembolism: results from a population-based case-crossover study |
topic_facet |
Diseases of the circulatory (Cardiovascular) system RC666-701 |
description |
Background: Surgery is a major transient risk factor for venous thromboembolism (VTE). However, the impact of major surgery as a VTE trigger has been scarcely investigated using a case-crossover design. Aim: To investigate the role of major surgery as a trigger for incident VTE in a population-based case-crossover study while adjusting for other concomitant VTE triggers. Methods: We conducted a case-crossover study with 531 cancer-free VTE cases derived from the Tromsø Study cohort. Triggers were registered during the 90 days before a VTE event (hazard period) and in four preceding 90-day control periods. Conditional logistic regression was used to estimate odds ratios (ORs) with 95% confidence intervals (CIs) for VTE according to major surgery and after adjustment for other VTE triggers. Results: Surgery was registered in 85 of the 531 (16.0%) hazard periods and in 38 of the 2124 (1.8%) control periods, yielding an OR for VTE of 11.40 (95% CI 7.42-17.51). The OR decreased to 4.10 (95% CI 2.40-6.94) after adjustment for immobilization and infection and was further attenuated to 3.31 (95% CI 1.83-5.96) when additionally adjusted for trauma, blood transfusion and central venous catheter. In a mediation analysis, 51.4% (95% CI 35.5%-79.7%) of the effect of surgery on VTE risk could be mediated through immobilization and infection. Conclusions: Major surgery was a trigger for VTE, but the association between surgery and VTE risk was in part explained by other VTE triggers often coexisting with surgery, particularly immobilization and infection. |
format |
Article in Journal/Newspaper |
author |
Dana Meknas Sigrid Kufaas Brækkan John-Bjarne Hansen Vania Maris Morelli |
author_facet |
Dana Meknas Sigrid Kufaas Brækkan John-Bjarne Hansen Vania Maris Morelli |
author_sort |
Dana Meknas |
title |
Surgery as a trigger for incident venous thromboembolism: results from a population-based case-crossover study |
title_short |
Surgery as a trigger for incident venous thromboembolism: results from a population-based case-crossover study |
title_full |
Surgery as a trigger for incident venous thromboembolism: results from a population-based case-crossover study |
title_fullStr |
Surgery as a trigger for incident venous thromboembolism: results from a population-based case-crossover study |
title_full_unstemmed |
Surgery as a trigger for incident venous thromboembolism: results from a population-based case-crossover study |
title_sort |
surgery as a trigger for incident venous thromboembolism: results from a population-based case-crossover study |
publisher |
Georg Thieme Verlag KG |
url |
https://doi.org/10.1055/a-2159-9957 https://doaj.org/article/0579b6c97b8a460da83e4c618fa9e3f7 |
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Tromsø |
geographic_facet |
Tromsø |
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Tromsø |
genre_facet |
Tromsø |
op_source |
TH Open, Vol , Iss |
op_relation |
http://www.thieme-connect.de/DOI/DOI?10.1055/a-2159-9957 https://doaj.org/toc/2512-9465 2512-9465 doi:10.1055/a-2159-9957 https://doaj.org/article/0579b6c97b8a460da83e4c618fa9e3f7 |
op_doi |
https://doi.org/10.1055/a-2159-9957 |
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TH Open |
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07 |
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03 |
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1778150140769468416 |