4 Citations (Scopus)

Abstract

PURPOSE: In this study, we aimed to estimate recurrence risk after incident venous thromboembolism, stratified according to unprovoked, provoked, and cancer-related venous thromboembolism in a prospective cohort of inpatients and outpatients receiving routine care. METHODS: We linked nationwide Danish health registries to identify all patients with incident venous thromboembolism from January 2000 through December 2015. Rates of recurrence were calculated and Cox regression was used to compute hazard ratios (HRs) with 95% confidence intervals (CIs) by incident venous thromboembolism type after adjusting for coexisting risk factors. RESULTS: The study included 73,993 patients with incident venous thromboembolism (54.1% females; mean age, 62.3 years). At 6-month follow-up, rates per 100 person-years were 6.80, 6.92, and 9.06 for provoked, unprovoked, and cancer-related venous thromboembolism, respectively. At 10-year follow-up, corresponding rates were 2.22, 2.84, and 3.70, respectively. Additionally, at 6-month follow-up, hazard rates of recurrence were comparable for patients with unprovoked venous thromboembolism 1.01 (95% CI, 0.92-1.11) and provoked. At 10-year follow-up, unprovoked venous thromboembolism (HR, 1.17; 95% CI, 1.12-1.23) and cancer -related venous thromboembolism (HR, 1.21; 95% CI, 1.12-1.32) were associated with higher risk of recurrence compared with that found in provoked venous thromboembolism. CONCLUSIONS: In this nationwide cohort, patients with cancer -related venous thromboembolism had the highest risk of recurrence. At 6-month follow-up, there were similar risks of recurrence for patients with unprovoked and provoked venous thromboembolism. At 10-year follow-up, recurrence risks were similar for patients with unprovoked venous thromboembolism and patients with cancer -related venous thromboembolism. High recurrence risks in all categories indicate that further research is needed to optimize duration of extended anticoagulation for these patients. (C) 2018 Elsevier Inc. All rights reserved.
Original languageEnglish
JournalAmerican Journal of Medicine
Volume131
Issue number9
Pages (from-to)1067-1074
Number of pages8
ISSN0002-9343
DOIs
Publication statusPublished - 1 Sep 2018

Keywords

  • Cancer Recurrence
  • Provoked
  • Unprovoked
  • Venous thromboembolism

Cite this

@article{0dd0f21b305542f48196deb1445cf741,
title = "Risk of Recurrent Venous Thromboembolism: A Danish Nationwide Cohort Study",
abstract = "PURPOSE: In this study, we aimed to estimate recurrence risk after incident venous thromboembolism, stratified according to unprovoked, provoked, and cancer-related venous thromboembolism in a prospective cohort of inpatients and outpatients receiving routine care. METHODS: We linked nationwide Danish health registries to identify all patients with incident venous thromboembolism from January 2000 through December 2015. Rates of recurrence were calculated and Cox regression was used to compute hazard ratios (HRs) with 95{\%} confidence intervals (CIs) by incident venous thromboembolism type after adjusting for coexisting risk factors. RESULTS: The study included 73,993 patients with incident venous thromboembolism (54.1{\%} females; mean age, 62.3 years). At 6-month follow-up, rates per 100 person-years were 6.80, 6.92, and 9.06 for provoked, unprovoked, and cancer-related venous thromboembolism, respectively. At 10-year follow-up, corresponding rates were 2.22, 2.84, and 3.70, respectively. Additionally, at 6-month follow-up, hazard rates of recurrence were comparable for patients with unprovoked venous thromboembolism 1.01 (95{\%} CI, 0.92-1.11) and provoked. At 10-year follow-up, unprovoked venous thromboembolism (HR, 1.17; 95{\%} CI, 1.12-1.23) and cancer -related venous thromboembolism (HR, 1.21; 95{\%} CI, 1.12-1.32) were associated with higher risk of recurrence compared with that found in provoked venous thromboembolism. CONCLUSIONS: In this nationwide cohort, patients with cancer -related venous thromboembolism had the highest risk of recurrence. At 6-month follow-up, there were similar risks of recurrence for patients with unprovoked and provoked venous thromboembolism. At 10-year follow-up, recurrence risks were similar for patients with unprovoked venous thromboembolism and patients with cancer -related venous thromboembolism. High recurrence risks in all categories indicate that further research is needed to optimize duration of extended anticoagulation for these patients. (C) 2018 Elsevier Inc. All rights reserved.",
keywords = "Cancer Recurrence, Provoked, Unprovoked, Venous thromboembolism",
author = "Albertsen, {Ida Ehlers} and Nielsen, {Peter Bronnum} and Mette Sogaard and Goldhaber, {Samuel Zachary} and Overvad, {Thure Filskov} and Rasmussen, {Lars Hvilsted} and Larsen, {Torben Bjerregaard}",
year = "2018",
month = "9",
day = "1",
doi = "10.1016/j.amjmed.2018.04.042",
language = "English",
volume = "131",
pages = "1067--1074",
journal = "American Journal of Medicine",
issn = "0002-9343",
publisher = "Elsevier",
number = "9",

}

Risk of Recurrent Venous Thromboembolism : A Danish Nationwide Cohort Study. / Albertsen, Ida Ehlers; Nielsen, Peter Bronnum; Sogaard, Mette; Goldhaber, Samuel Zachary; Overvad, Thure Filskov; Rasmussen, Lars Hvilsted; Larsen, Torben Bjerregaard.

In: American Journal of Medicine, Vol. 131, No. 9, 01.09.2018, p. 1067-1074.

Research output: Contribution to journalJournal articleResearchpeer-review

TY - JOUR

T1 - Risk of Recurrent Venous Thromboembolism

T2 - A Danish Nationwide Cohort Study

AU - Albertsen, Ida Ehlers

AU - Nielsen, Peter Bronnum

AU - Sogaard, Mette

AU - Goldhaber, Samuel Zachary

AU - Overvad, Thure Filskov

AU - Rasmussen, Lars Hvilsted

AU - Larsen, Torben Bjerregaard

PY - 2018/9/1

Y1 - 2018/9/1

N2 - PURPOSE: In this study, we aimed to estimate recurrence risk after incident venous thromboembolism, stratified according to unprovoked, provoked, and cancer-related venous thromboembolism in a prospective cohort of inpatients and outpatients receiving routine care. METHODS: We linked nationwide Danish health registries to identify all patients with incident venous thromboembolism from January 2000 through December 2015. Rates of recurrence were calculated and Cox regression was used to compute hazard ratios (HRs) with 95% confidence intervals (CIs) by incident venous thromboembolism type after adjusting for coexisting risk factors. RESULTS: The study included 73,993 patients with incident venous thromboembolism (54.1% females; mean age, 62.3 years). At 6-month follow-up, rates per 100 person-years were 6.80, 6.92, and 9.06 for provoked, unprovoked, and cancer-related venous thromboembolism, respectively. At 10-year follow-up, corresponding rates were 2.22, 2.84, and 3.70, respectively. Additionally, at 6-month follow-up, hazard rates of recurrence were comparable for patients with unprovoked venous thromboembolism 1.01 (95% CI, 0.92-1.11) and provoked. At 10-year follow-up, unprovoked venous thromboembolism (HR, 1.17; 95% CI, 1.12-1.23) and cancer -related venous thromboembolism (HR, 1.21; 95% CI, 1.12-1.32) were associated with higher risk of recurrence compared with that found in provoked venous thromboembolism. CONCLUSIONS: In this nationwide cohort, patients with cancer -related venous thromboembolism had the highest risk of recurrence. At 6-month follow-up, there were similar risks of recurrence for patients with unprovoked and provoked venous thromboembolism. At 10-year follow-up, recurrence risks were similar for patients with unprovoked venous thromboembolism and patients with cancer -related venous thromboembolism. High recurrence risks in all categories indicate that further research is needed to optimize duration of extended anticoagulation for these patients. (C) 2018 Elsevier Inc. All rights reserved.

AB - PURPOSE: In this study, we aimed to estimate recurrence risk after incident venous thromboembolism, stratified according to unprovoked, provoked, and cancer-related venous thromboembolism in a prospective cohort of inpatients and outpatients receiving routine care. METHODS: We linked nationwide Danish health registries to identify all patients with incident venous thromboembolism from January 2000 through December 2015. Rates of recurrence were calculated and Cox regression was used to compute hazard ratios (HRs) with 95% confidence intervals (CIs) by incident venous thromboembolism type after adjusting for coexisting risk factors. RESULTS: The study included 73,993 patients with incident venous thromboembolism (54.1% females; mean age, 62.3 years). At 6-month follow-up, rates per 100 person-years were 6.80, 6.92, and 9.06 for provoked, unprovoked, and cancer-related venous thromboembolism, respectively. At 10-year follow-up, corresponding rates were 2.22, 2.84, and 3.70, respectively. Additionally, at 6-month follow-up, hazard rates of recurrence were comparable for patients with unprovoked venous thromboembolism 1.01 (95% CI, 0.92-1.11) and provoked. At 10-year follow-up, unprovoked venous thromboembolism (HR, 1.17; 95% CI, 1.12-1.23) and cancer -related venous thromboembolism (HR, 1.21; 95% CI, 1.12-1.32) were associated with higher risk of recurrence compared with that found in provoked venous thromboembolism. CONCLUSIONS: In this nationwide cohort, patients with cancer -related venous thromboembolism had the highest risk of recurrence. At 6-month follow-up, there were similar risks of recurrence for patients with unprovoked and provoked venous thromboembolism. At 10-year follow-up, recurrence risks were similar for patients with unprovoked venous thromboembolism and patients with cancer -related venous thromboembolism. High recurrence risks in all categories indicate that further research is needed to optimize duration of extended anticoagulation for these patients. (C) 2018 Elsevier Inc. All rights reserved.

KW - Cancer Recurrence

KW - Provoked

KW - Unprovoked

KW - Venous thromboembolism

U2 - 10.1016/j.amjmed.2018.04.042

DO - 10.1016/j.amjmed.2018.04.042

M3 - Journal article

VL - 131

SP - 1067

EP - 1074

JO - American Journal of Medicine

JF - American Journal of Medicine

SN - 0002-9343

IS - 9

ER -