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J Thromb Haemost. 2014;12(3):290-6. doi: 10.1111/jth.12480.

The contribution of immobility risk factors to the incidence of venous thrombosis in an older population.

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1
Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands.

Abstract

BACKGROUND:

Venous thrombosis is common in the older population. Assessment of risk factors is necessary to implement preventive measures.

OBJECTIVES:

We studied the associations between immobility-related risk factors and thrombosis, specifically, hospitalization, surgery, fractures, plaster cast use, minor injuries, and transient immobility at home, in an older population.

PATIENTS AND METHODS:

Analyses were performed in the Age and Thrombosis, Acquired and Genetic risk factors in the Elderly (AT-AGE) study, a two-center population-based case-control study. Consecutive cases aged > 70 years with a first-time thrombosis (n = 401) and control subjects > 70 years old without a history of thrombosis (n = 431) were included. Exclusion criteria were active malignancy and severe cognitive disorders. We calculated odds ratios (OR) with 95% confidence intervals (95% CI) after adjustment for age, sex, body mass index, study center, and population-attributable risks.

RESULTS:

There was a 15-fold (OR 14.8, 95% CI 4.4-50.4) increased risk of thrombosis within 2 weeks after hospital discharge. Surgery (OR 6.6, 95% CI 3.7-11.6), fractures (OR 12.7, 95% CI 3.7-43.7), plaster cast (OR 6.2, 95% CI 2.0-18.9), minor leg injuries (OR 1.9, 95% CI 1.1-3.3), and transient immobility at home (OR 5.0, 95% CI 2.3-11.2) were all associated with thrombosis risk over 3 months. The population-attributable risks for in-hospital immobility was 27%, and for out-of-hospital immobility, 15%.

CONCLUSIONS:

In those > 70 years of age, in-hospital and out-of hospital immobility are strong risk factors for thrombosis. Additional studies on preventive measures during immobilization in this age group should not focus solely on hospital settings.

KEYWORDS:

aged; immobilization; population at risk; pulmonary embolism; risk factors; venous thrombosis

PMID:
24330554
DOI:
10.1111/jth.12480
[Indexed for MEDLINE]
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