An overview of temporary acquired risk factors and chronic acquired risk factors for PE and DVT
| Temporary acquired risk factors . | Study design and N . | Country where study was conducted . | Age, y . | PE (95% CI) . | DVT (95% CI) . | DVT + PE (95% CI) . |
|---|---|---|---|---|---|---|
| Immobilization/stasis | ||||||
| Travel | Cohort | United States | Mean (SD) 49 (17) | |||
| Beam (2009)28 | N total = 7940 | RR = 1.2 (0.79-1.7)* | RR = 0.64 (0.20-2.1)* | RR = 1.3 (0.68-2.5)* | ||
| Cannegieter (2006)29 | Case-control | The Netherlands | Median, range cases | |||
| Long haul flight | N total = 3812 | 50 (18-69) | OR = 0.64 (0.25-1.6) | OR = 3.0 (1.3-7.1) | — | |
| Bus, car, train | N cases = 1906 | OR = 4.0 (1.5-10.7) | OR = 1.9 (1.1-3.2) | — | ||
| Neurologic | Cohort | United States | Mean (SD) 49 (17) | |||
| Beam (2009)28 | N total = 7940 | RR = 9.7 (6.6-14.3)* | RR = 7.9 (2.5-25.4)* | RR = 3.4 (0.83-13.7)* | ||
| Surgery and trauma | ||||||
| Plaster cast | Cohort | United States | Mean (SD) 49 (17) | |||
| Beam (2009)28 | N total = 7940 | RR = 3.0 (1.9-5.0)* | RR = 3.0 (0.95-9.8)* | RR = 4.3 (2.0-9.3)* | ||
| Surgery | Cohort | United Kingdom | Mean, SD 56 (4.6) | |||
| Sweetland (2009)30 | (women) | |||||
| Risk < 6 wks postoperatively | N total = 947 454 | RR = 41.5 (36.9-46.7)* | RR = 31.7 (28.4-35.3)* | — | ||
| Risk 4-12 mo postoperatively | RR = 4.4 (3.8-5.1)* | RR = 4.8 (4.3-5.4)* | — | |||
| MEGA (unpublished data) | Case-control | The Netherlands | Mean, range | |||
| Risk < 1 y postoperatively | N total = 11 145 | 48, 18-72 (total) | OR = 4.3 (3.7-5.1)† | OR = 4.0 (3.5-4.6)† | OR = 3.4 (2.6-4.4)† | |
| N cases = 4903 | 49, 18-72 (cases) | |||||
| Minor leg injury | Case-control | The Netherlands | Median (5th-95th percentiles) cases | |||
| Van Stralen (2008)31 | N total = 6005 | 48 (25-68) | OR = 2.4 (1.6-3.7) | OR = 6.3 (4.7-8.5) | OR = 5.3 (3.2-8.7) | |
| N cases = 2471 | ||||||
| Reproduction | ||||||
| Oral contraceptives | Case-control | The Netherlands | Mean, range | |||
| Van Hylckama Vlieg (2009)32 | N total = 3284 | 37, 18-49 (total) | OR = 3.9 (3.2-4.8)‡ | OR = 6.6 (5.4-8.0) | — | |
| N cases = 1524 | 37, 18-49 (cases) | |||||
| WHO (1995)33 | Case-control | Africa, Asia, Europe, and Latin America | Mean, SD | Europe | Europe | |
| N total = 4141 | 33 (7) | OR = 2.5 (0.95-6.8) | OR = 4.1 (2.8-6.1) | — | ||
| N cases = 1143 | Other countries | Other countries | ||||
| OR = 7.1 (1.4-36.8) | OR = 4.6 (3.0-7.1) | — | ||||
| Pregnancy | Cohort | United States | Mean, range | |||
| Heit (2005)36 | N total = 50 080 | 28 (17-44) | IRR = 0.23 (0.07-0.71)§ | IRR = 1.9 (1.3-2.7)§ | — | |
| McColl (1997)34 | Cohort N total = 72 201 | United Kingdom | Mean, range 29 (19-41) | IR 0.07 (0.01-0.13) per 1000 deliveries | IR 0.50 (0.34-0.66) per 1000 deliveries | — |
| Pomp (2008)35 | Case-control | The Netherlands | Mean, (5th-95th percentile) | |||
| N total = 1142 | 38 (26-50) cases | |||||
| N cases = 285 | OR = 2.3 (1.0-5.2) | OR = 7.8 (4.1-15.0) | — | |||
| Puerperium | Cohort | United States | Mean, range | |||
| Heit (2005)36 | N total = 50 080 | 28 (17-44) | IRR = 3.5 (2.2-5.6)§ | IRR = 7.6 (5.5-10.6)§ | — | |
| Risk < 3 mo postpartum | ||||||
| McColl (1997)34 | Cohort | United Kingdom | Mean, range | |||
| Risk < 6 wks postpartum | N total = 72 201 | 29 (19-41) | IR 0.08 (0.02-0.14) per 1000 deliveries | IR 0.21 (0.11-0.31) per 1000 deliveries | — | |
| Pomp (2008)35 | Case-control | The Netherlands | Mean, (5th-95th percentile) | |||
| Risk < 3 mo postpartum (women > 18 y) | N total = 1142 | 38 (26-50) cases | OR = 34.4 (13.3-88.5) | OR = 72.6 (30.1-175.4) | OR = 46.4 (10.0-214.7) | |
| N cases = 285 | ||||||
| Lifestyle | ||||||
| Exercise | Case-control | The Netherlands | Median (5th-95th percentile) | |||
| Van Stralen (2007)40 | N total = 7860 | 47 (25-67) total | ||||
| N cases = 3608 | 48 (26-67) cases | OR = 0.54 (0.46-0.64) | OR = 0.76 (0.67-0.86) | OR = 0.79 (0.63-0.98) | ||
| Smoking | Case-control | The Netherlands | 47 (5th-95th percentile 25-66) | |||
| Pomp (2008)42 | N total = 8889 | |||||
| Current smoking | N cases = 3989 | OR = 1.5 (1.3-1.8) | OR = 1.5 (1.3-1.7) | OR = 1.2 (0.96-1.5) | ||
| Former smoking | OR = 1.4 (1.2-1.6) | OR = 1.2 (1.0-1.4) | OR = 0.99 (0.78-1.3) | |||
| Alcohol | Case-control | The Netherlands | Mean (5th-95th percentile) | |||
| Pomp (2008)43 | N total = 9658 | 47 (25-67) total | OR = 0.56 (0.46-0.70) | OR = 0.74 (0.63-0.80) | — | |
| N cases = 4423 | 49 (26-68) cases | |||||
| Chronic acquired factors | ||||||
| Cancer | Case-control | The Netherlands | Median (5th-95th percentile) | |||
| Blom (2005)44 | N total = 5351 | 50 (26-68) total | ||||
| N cases = 3220 | 50 (26-68) cases | OR = 4.6 (3.6-6.4)‡ | OR = 4.0 (3.0-5.3) | — | ||
| COPD | Nested case-control | United Kingdom | — | |||
| Schneider (2010)48 | N total = 71 544 | |||||
| Mild | N cases = 346 | OR = 3.6 (1.3-9.7) | OR = 1.7 (0.78-3.8) | — | ||
| Severe | OR = 7.5 (2.4-23.7) | OR = 0.79 (0.26-2.4) | — | |||
| Flinterman (manuscript in preparation)†† | Case-control | The Netherlands | Mean (SD) | |||
| N total = 10 033 | 48 (13) total | |||||
| N cases = 4281 | 49 (13) cases | OR = 3.2 (2.4-4.2) | OR = 1.6 (1.2-2.1) | — | ||
| Sickle cell trait | Cross-sectional | United States | — | |||
| Stein (2006)49 | N total = 99 267 000 | RR = 1.5 (1.4-1.6)‖ | RR = 0.75 (0.74-0.76) | — | ||
| Austin (2007)13 | Case-control | United States | Median (25th-75th percentile) | |||
| N total = 2454 | 49 (38-56) cases | |||||
| N cases = 1145 | OR = 3.9 (2.2-6.9) | OR = 1.1 (0.65-1.9) | OR = 2.5 (1.2-5.5) | |||
| IBD (Crohn and colitis ulcerosa) | Cohort | Manitoba, Canada | Mean 36.3 years | |||
| Bernstein (2001)53 | N total = 66 297 | Mean 42.0 years | ||||
| Crohn disease | IRR = 2.9 (1.8-4.7) | IRR = 4.7 (3.5-6.3) | — | |||
| Ulcerative colitis | IRR = 3.6 (2.5-5.2) | IRR = 2.8 (2.1-3.7) | — | |||
| Kidney disease | Case-control | The Netherlands | Mean (SD) | |||
| Ocak (manuscript submitted)a | N total = 8732 | 48.7 (13.1) cases | ||||
| N cases = 3423 | OR = 4.2 (2.4-7.2)† | OR = 3.3 (1.9-5.6)† | — | |||
| Hyperthyroidism | Case-control | Norway, TROL study | — | |||
| Debeij (manuscript in preparation)b | N total = 1677 | |||||
| FT4 > 95th percentile of levels in controls | N cases = 446 | OR = 1.2 (0.50-2.7)# | OR = 2.0 (1.2-3.5)# | OR = 1.0 (0.10-8.1)# | ||
| Debeij (manuscript in preparation)c | Case-control | The Netherlands | — | |||
| FT4 > 24pM (cutoff for hyperthyroidism) | N total = 5003 | |||||
| N cases = 2177 | OR = 2.2 (0.6-8.3)** | OR = 2.7 (1.2-6.2)** | — | |||
| Temporary acquired risk factors . | Study design and N . | Country where study was conducted . | Age, y . | PE (95% CI) . | DVT (95% CI) . | DVT + PE (95% CI) . |
|---|---|---|---|---|---|---|
| Immobilization/stasis | ||||||
| Travel | Cohort | United States | Mean (SD) 49 (17) | |||
| Beam (2009)28 | N total = 7940 | RR = 1.2 (0.79-1.7)* | RR = 0.64 (0.20-2.1)* | RR = 1.3 (0.68-2.5)* | ||
| Cannegieter (2006)29 | Case-control | The Netherlands | Median, range cases | |||
| Long haul flight | N total = 3812 | 50 (18-69) | OR = 0.64 (0.25-1.6) | OR = 3.0 (1.3-7.1) | — | |
| Bus, car, train | N cases = 1906 | OR = 4.0 (1.5-10.7) | OR = 1.9 (1.1-3.2) | — | ||
| Neurologic | Cohort | United States | Mean (SD) 49 (17) | |||
| Beam (2009)28 | N total = 7940 | RR = 9.7 (6.6-14.3)* | RR = 7.9 (2.5-25.4)* | RR = 3.4 (0.83-13.7)* | ||
| Surgery and trauma | ||||||
| Plaster cast | Cohort | United States | Mean (SD) 49 (17) | |||
| Beam (2009)28 | N total = 7940 | RR = 3.0 (1.9-5.0)* | RR = 3.0 (0.95-9.8)* | RR = 4.3 (2.0-9.3)* | ||
| Surgery | Cohort | United Kingdom | Mean, SD 56 (4.6) | |||
| Sweetland (2009)30 | (women) | |||||
| Risk < 6 wks postoperatively | N total = 947 454 | RR = 41.5 (36.9-46.7)* | RR = 31.7 (28.4-35.3)* | — | ||
| Risk 4-12 mo postoperatively | RR = 4.4 (3.8-5.1)* | RR = 4.8 (4.3-5.4)* | — | |||
| MEGA (unpublished data) | Case-control | The Netherlands | Mean, range | |||
| Risk < 1 y postoperatively | N total = 11 145 | 48, 18-72 (total) | OR = 4.3 (3.7-5.1)† | OR = 4.0 (3.5-4.6)† | OR = 3.4 (2.6-4.4)† | |
| N cases = 4903 | 49, 18-72 (cases) | |||||
| Minor leg injury | Case-control | The Netherlands | Median (5th-95th percentiles) cases | |||
| Van Stralen (2008)31 | N total = 6005 | 48 (25-68) | OR = 2.4 (1.6-3.7) | OR = 6.3 (4.7-8.5) | OR = 5.3 (3.2-8.7) | |
| N cases = 2471 | ||||||
| Reproduction | ||||||
| Oral contraceptives | Case-control | The Netherlands | Mean, range | |||
| Van Hylckama Vlieg (2009)32 | N total = 3284 | 37, 18-49 (total) | OR = 3.9 (3.2-4.8)‡ | OR = 6.6 (5.4-8.0) | — | |
| N cases = 1524 | 37, 18-49 (cases) | |||||
| WHO (1995)33 | Case-control | Africa, Asia, Europe, and Latin America | Mean, SD | Europe | Europe | |
| N total = 4141 | 33 (7) | OR = 2.5 (0.95-6.8) | OR = 4.1 (2.8-6.1) | — | ||
| N cases = 1143 | Other countries | Other countries | ||||
| OR = 7.1 (1.4-36.8) | OR = 4.6 (3.0-7.1) | — | ||||
| Pregnancy | Cohort | United States | Mean, range | |||
| Heit (2005)36 | N total = 50 080 | 28 (17-44) | IRR = 0.23 (0.07-0.71)§ | IRR = 1.9 (1.3-2.7)§ | — | |
| McColl (1997)34 | Cohort N total = 72 201 | United Kingdom | Mean, range 29 (19-41) | IR 0.07 (0.01-0.13) per 1000 deliveries | IR 0.50 (0.34-0.66) per 1000 deliveries | — |
| Pomp (2008)35 | Case-control | The Netherlands | Mean, (5th-95th percentile) | |||
| N total = 1142 | 38 (26-50) cases | |||||
| N cases = 285 | OR = 2.3 (1.0-5.2) | OR = 7.8 (4.1-15.0) | — | |||
| Puerperium | Cohort | United States | Mean, range | |||
| Heit (2005)36 | N total = 50 080 | 28 (17-44) | IRR = 3.5 (2.2-5.6)§ | IRR = 7.6 (5.5-10.6)§ | — | |
| Risk < 3 mo postpartum | ||||||
| McColl (1997)34 | Cohort | United Kingdom | Mean, range | |||
| Risk < 6 wks postpartum | N total = 72 201 | 29 (19-41) | IR 0.08 (0.02-0.14) per 1000 deliveries | IR 0.21 (0.11-0.31) per 1000 deliveries | — | |
| Pomp (2008)35 | Case-control | The Netherlands | Mean, (5th-95th percentile) | |||
| Risk < 3 mo postpartum (women > 18 y) | N total = 1142 | 38 (26-50) cases | OR = 34.4 (13.3-88.5) | OR = 72.6 (30.1-175.4) | OR = 46.4 (10.0-214.7) | |
| N cases = 285 | ||||||
| Lifestyle | ||||||
| Exercise | Case-control | The Netherlands | Median (5th-95th percentile) | |||
| Van Stralen (2007)40 | N total = 7860 | 47 (25-67) total | ||||
| N cases = 3608 | 48 (26-67) cases | OR = 0.54 (0.46-0.64) | OR = 0.76 (0.67-0.86) | OR = 0.79 (0.63-0.98) | ||
| Smoking | Case-control | The Netherlands | 47 (5th-95th percentile 25-66) | |||
| Pomp (2008)42 | N total = 8889 | |||||
| Current smoking | N cases = 3989 | OR = 1.5 (1.3-1.8) | OR = 1.5 (1.3-1.7) | OR = 1.2 (0.96-1.5) | ||
| Former smoking | OR = 1.4 (1.2-1.6) | OR = 1.2 (1.0-1.4) | OR = 0.99 (0.78-1.3) | |||
| Alcohol | Case-control | The Netherlands | Mean (5th-95th percentile) | |||
| Pomp (2008)43 | N total = 9658 | 47 (25-67) total | OR = 0.56 (0.46-0.70) | OR = 0.74 (0.63-0.80) | — | |
| N cases = 4423 | 49 (26-68) cases | |||||
| Chronic acquired factors | ||||||
| Cancer | Case-control | The Netherlands | Median (5th-95th percentile) | |||
| Blom (2005)44 | N total = 5351 | 50 (26-68) total | ||||
| N cases = 3220 | 50 (26-68) cases | OR = 4.6 (3.6-6.4)‡ | OR = 4.0 (3.0-5.3) | — | ||
| COPD | Nested case-control | United Kingdom | — | |||
| Schneider (2010)48 | N total = 71 544 | |||||
| Mild | N cases = 346 | OR = 3.6 (1.3-9.7) | OR = 1.7 (0.78-3.8) | — | ||
| Severe | OR = 7.5 (2.4-23.7) | OR = 0.79 (0.26-2.4) | — | |||
| Flinterman (manuscript in preparation)†† | Case-control | The Netherlands | Mean (SD) | |||
| N total = 10 033 | 48 (13) total | |||||
| N cases = 4281 | 49 (13) cases | OR = 3.2 (2.4-4.2) | OR = 1.6 (1.2-2.1) | — | ||
| Sickle cell trait | Cross-sectional | United States | — | |||
| Stein (2006)49 | N total = 99 267 000 | RR = 1.5 (1.4-1.6)‖ | RR = 0.75 (0.74-0.76) | — | ||
| Austin (2007)13 | Case-control | United States | Median (25th-75th percentile) | |||
| N total = 2454 | 49 (38-56) cases | |||||
| N cases = 1145 | OR = 3.9 (2.2-6.9) | OR = 1.1 (0.65-1.9) | OR = 2.5 (1.2-5.5) | |||
| IBD (Crohn and colitis ulcerosa) | Cohort | Manitoba, Canada | Mean 36.3 years | |||
| Bernstein (2001)53 | N total = 66 297 | Mean 42.0 years | ||||
| Crohn disease | IRR = 2.9 (1.8-4.7) | IRR = 4.7 (3.5-6.3) | — | |||
| Ulcerative colitis | IRR = 3.6 (2.5-5.2) | IRR = 2.8 (2.1-3.7) | — | |||
| Kidney disease | Case-control | The Netherlands | Mean (SD) | |||
| Ocak (manuscript submitted)a | N total = 8732 | 48.7 (13.1) cases | ||||
| N cases = 3423 | OR = 4.2 (2.4-7.2)† | OR = 3.3 (1.9-5.6)† | — | |||
| Hyperthyroidism | Case-control | Norway, TROL study | — | |||
| Debeij (manuscript in preparation)b | N total = 1677 | |||||
| FT4 > 95th percentile of levels in controls | N cases = 446 | OR = 1.2 (0.50-2.7)# | OR = 2.0 (1.2-3.5)# | OR = 1.0 (0.10-8.1)# | ||
| Debeij (manuscript in preparation)c | Case-control | The Netherlands | — | |||
| FT4 > 24pM (cutoff for hyperthyroidism) | N total = 5003 | |||||
| N cases = 2177 | OR = 2.2 (0.6-8.3)** | OR = 2.7 (1.2-6.2)** | — | |||
— indicates not applicable.
Crude RR = calculated using data from Table 2 from the original article.
Adjusted for age and sex.
PE with or without a DVT of the leg.
Calculated from Table 1 from the original article.
Calculated from the “Results” section of the original article.
¶Adjusted for age, sex, diabetes, and BMI.
Adjusted for age, sex, and BMI.
Adjusted for age, sex, BMI, and smoking.
L.E.F., A.v.H.V., van Kralingen KW, S.C.C., and F.R.R., Chronic obstructive pulmonary disease and pulmonary embolism, manuscript in preparation.
Ocak G, Vossen CY, Verduijn M, Dekker FW, F.R.R., S.C.C, and Lijfering WM, Risk of venous thrombosis in persons with major illnesses: results from the MEGA study, manuscript under revision.
Debeij J, Dekkers OM, Asvold BO, Christiansen SC, Naess IA, Hammerstrong J, F.R.R., and S.C.C., Increased levels of thyroxine and risk of venous thrombosis in large population-based prospective study, manuscript accepted, J Thromb Haemost., June 15, 2012.
Debeij J, van Zaane B, Dekkers OM, Doggen CJM, Smit JWA, van Zanten AP, Brandjes DPM, Büller HR, Gerdes VEA, F.R.R., and S.C.C., High levels of free thyroxine increased levels of coagulation factors and the risk of venous thrombosis: results of a large population-based case-control study (MEGA-study), manuscript in preparation.