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dc.contributor.authorPiazza, Gregory
dc.contributor.authorGoldhaber, Samuel Z.
dc.contributor.authorKroll, Aimee
dc.contributor.authorGoldberg, Robert J.
dc.contributor.authorEmery, Catherine
dc.contributor.authorSpencer, Frederick A.
dc.date2022-08-11T08:10:33.000
dc.date.accessioned2022-08-23T17:12:43Z
dc.date.available2022-08-23T17:12:43Z
dc.date.issued2012-07-01
dc.date.submitted2012-10-23
dc.identifier.citationAm J Med. 2012 Jul;125(7):709-16. Epub 2012 May 3. <a href="http://dx.doi.org/10.1016/j.amjmed.2011.12.004" target="_blank">Link to article on publisher's site</a>
dc.identifier.issn0002-9343 (Linking)
dc.identifier.doi10.1016/j.amjmed.2011.12.004
dc.identifier.pmid22560173
dc.identifier.urihttp://hdl.handle.net/20.500.14038/46566
dc.description.abstractPURPOSE: 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.
dc.language.isoen_US
dc.relation<a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&list_uids=22560173&dopt=Abstract">Link to Article in PubMed</a>
dc.relation.urlhttp://dx.doi.org/10.1016/j.amjmed.2011.12.004
dc.subjectAdult
dc.subjectAged
dc.subjectAged, 80 and over
dc.subjectComorbidity
dc.subjectDiabetes Complications
dc.subjectFemale
dc.subjectHumans
dc.subjectMale
dc.subjectMassachusetts
dc.subjectMiddle Aged
dc.subjectRisk Factors
dc.subjectVenous Thromboembolism
dc.subjectCardiovascular Diseases
dc.subjectEndocrine System Diseases
dc.subjectEpidemiology
dc.subjectHealth Services Research
dc.subjectNutritional and Metabolic Diseases
dc.titleVenous thromboembolism in patients with diabetes mellitus
dc.typeJournal Article
dc.source.journaltitleThe American journal of medicine
dc.source.volume125
dc.source.issue7
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/qhs_pp/1031
dc.identifier.contextkey3418827
html.description.abstract<p>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.</p> <p>METHODS: We studied diabetic patients in the population-based Worcester Venous Thromboembolism Study of 2488 consecutive patients with validated venous thromboembolism.</p> <p>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.</p> <p>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.</p>
dc.identifier.submissionpathqhs_pp/1031
dc.contributor.departmentMeyers Primary Care Institute
dc.contributor.departmentDepartment of Quantitative Health Sciences
dc.contributor.departmentDepartment of Medicine, Division of Cardiovascular Medicine
dc.source.pages709-16


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