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    Venous thromboembolism in patients with diabetes mellitus

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    Authors
    Piazza, Gregory
    Goldhaber, Samuel Z.
    Kroll, Aimee
    Goldberg, Robert J.
    Emery, Catherine
    Spencer, Frederick A.
    UMass Chan Affiliations
    Meyers Primary Care Institute
    Department of Quantitative Health Sciences
    Department of Medicine, Division of Cardiovascular Medicine
    Document Type
    Journal Article
    Publication Date
    2012-07-01
    Keywords
    Adult
    Aged
    Aged, 80 and over
    Comorbidity
    Diabetes Complications
    Female
    Humans
    Male
    Massachusetts
    Middle Aged
    Risk Factors
    Venous Thromboembolism
    Cardiovascular Diseases
    Endocrine System Diseases
    Epidemiology
    Health Services Research
    Nutritional and Metabolic Diseases
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    http://dx.doi.org/10.1016/j.amjmed.2011.12.004
    Abstract
    PURPOSE: The majority of epidemiological studies demonstrate an increased risk of venous thromboembolism among diabetic patients. Our aim was to compare clinical characteristics, prophylaxis, treatment, and outcomes of venous thromboembolism in patients with and without previously diagnosed diabetes. METHODS: We studied diabetic patients in the population-based Worcester Venous Thromboembolism Study of 2488 consecutive patients with validated venous thromboembolism. RESULTS: Of 2488 venous thromboembolism patients, 476 (19.1%) had a clinical history of diabetes. Thromboprophylaxis was omitted in more than one third of diabetic patients who had been hospitalized for non-venous-thromboembolism-related illness or had undergone major surgery within 3 months before diagnosis. Patients with diabetes were more likely than nondiabetic patients to have a complicated course after venous thromboembolism. Patients with diabetes were more likely than patients without diabetes to suffer recurrent deep vein thrombosis (14.9% vs 10.7%) and long-term major bleeding complications (16.4% vs 11.7%) (all P=.01). Diabetes was associated with a significant increase in the risk of recurrent deep vein thrombosis (adjusted odds ratio [AOR] 1.74; 95% confidence interval [CI], 1.21-2.51). Aspirin therapy at discharge (AOR 1.59; 95% CI, 1.1-2.3) and chronic kidney disease (AOR 2.19; 95% CI, 1.44-3.35) were independent predictors of long-term major bleeding. CONCLUSION: Patients with diabetes who developed venous thromboembolism were more likely to suffer a complicated clinical course. Diabetes was an independent predictor of recurrent deep vein thrombosis. We observed a low rate of thromboprophylaxis in diabetic patients. Further studies should focus on venous thromboembolism prevention in this vulnerable population.
    Source
    Am J Med. 2012 Jul;125(7):709-16. Epub 2012 May 3. Link to article on publisher's site
    DOI
    10.1016/j.amjmed.2011.12.004
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/46566
    PubMed ID
    22560173
    Related Resources
    Link to Article in PubMed
    ae974a485f413a2113503eed53cd6c53
    10.1016/j.amjmed.2011.12.004
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