Tuberculosis and Respiratory Diseases

The Korean Academy of Tuberculosis and Respiratory Diseases (대한결핵및호흡기학회)
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Incidence and Risk Factors of Recurrent Venous Thromboembolism after Pulmonary Embolism

  • Hwang, Hun-Gyu (Respiratory Division, Department of Internal Medicine, Soonchunhyang University Gumi Hospital) ;
  • Choi, Won-Il (Department of Medicine, Keimyung University Dongsan Hospital) ;
  • Lee, Bora (Department of Biostatistic Consulting, Soonchunhyang University Bucheon Hospital) ;
  • Lee, Choong Won (Department of Occupational and Environmental Medicine, Sungso Hospital)
  • Received : 2019.03.04
  • Accepted : 2019.05.17
  • Published : 2019.10.31
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Abstract

Background: Information about the epidemiology of venous thromboembolism (VTE) recurrence in Korea is lacking. The purpose of this study was to investigate VTE cumulative recurrence rates and identify risk factors for VTE recurrence among Korean adults. Methods: A retrospective cohort study was conducted on adult patients (${\geq}18years$) admitted to a university teaching hospital for pulmonary embolism (PE) from 2005 to 2013. The main outcome of interest was a recurrence of VTE. We used Cox proportional hazard regression analyses to calculate the relative risk of VTE recurrence. Results: Five-year cumulative incidence of recurrent VTE events was 21.5% (95% confidence interval [CI], 17.7-25.4) in all cases of PE; 17% after provoked and 27% after unprovoked PE. Multivariate analysis showed that body mass index (BMI) of ${\geq}25$ (hazard ratio [HR], 2.02; 95% CI, 1.17-3.46; p=0.01) and longer anticoagulation therapy duration (HR, 0.90; 95% CI, 0.84-0.96; p<0.01) were independently associated with risk of VTE recurrence. Risk factors not found to be statistically significant at the <0.05 level included history of VTE (HR, 1.81; 95% CI, 0.84-3.88; p=0.12), unprovoked PE (HR, 1.70; 95% CI, 0.89-3.25; p=0.10), symptomatic deep vein thrombosis (HR, 1.62; 95% CI, 0.89-2.94; p=0.10), and female sex (HR, 1.42; 95% CI, 0.78-2.55; p=0.24). We found that age, history of cancer, and other co-morbidities did not significantly affect the risk of VTE recurrence. Conclusion: Recurrence of VTE after PE is high. Patients with BMI ${\geq}25$ or reduced anticoagulation therapy duration have a higher risk of recurrent VTE.

Keywords

Acknowledgement

Supported by : National Research Foundation of Korea (NRF)

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