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Increased risk of venous thromboembolism within the first year after S taphylococcus aureus bacteraemia: a nationwide observational matched cohort study
Author(s) -
Mejer N.,
Westh H.,
Schønheyder H. C.,
Jensen A. G.,
Larsen A.R.,
Skov R.,
Benfield T.
Publication year - 2014
Publication title -
journal of internal medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.625
H-Index - 160
eISSN - 1365-2796
pISSN - 0954-6820
DOI - 10.1111/joim.12147
Subject(s) - medicine , pulmonary embolism , hazard ratio , confidence interval , deep vein , incidence (geometry) , observational study , cohort study , population , cohort , venous thrombosis , bacteremia , surgery , thrombosis , pediatrics , antibiotics , physics , microbiology and biotechnology , environmental health , optics , biology
Abstract Objectives Recent evidence suggests that there is an association between infection and venous thromboembolism ( VTE ). Here, we examined the risk of VTE after S taphylococcus aureus bacteraemia ( SAB ) compared to the risk in control subjects. Design and setting Register‐based nationwide observational cohort study of hospitalized patients and matched control subjects from the general population in D enmark between 1995 and 2008. Results Amongst 15 669 SAB cases and 156 690 controls, 182 and 511, respectively, experienced VTE within 1 year. The overall incidence rate ( IR ) of VTE amongst cases was highest within the first 30 days [ IR of deep vein thrombosis ( DVT ), 39.3 (95% confidence interval ( CI ) 28.9–53.4)/1000 person‐years ( PY s); IR of pulmonary embolism ( PE ), 16.3 (95% CI 10.1–26.2)/1000 PY s]. IR s of DVT were particularly increased amongst cases with a previous diagnosis of VTE , community‐acquired infection, a history of injection drug use and in younger age groups. The overall hazard ratio of VTE for cases compared to controls declined from 15.6 (95% CI 10.3–23.5) in the first 30 days after SAB to 4.5 (95% CI 3.2–6.2) from 181 to 365 days after infection. The increased risk of VTE amongst SAB patients persisted after excluding cases with identified VTE risk factors. Conclusions There was a particularly high risk of VTE during the first month following an episode of SAB . The risk declined over time, but remained at a threefold increased level compared to control subjects, suggesting that there are shared risk factors for SAB and VTE . Patients with SAB and well‐documented risk factors for VTE may benefit from thromboprophylaxis.