The objective of this investigation is to explore a possible role of thyroid dysfunction in venous thromboembolism (VTE). The number of patients discharged from short-stay nonfederal hospitals in the United States, from 1979 to 2005, with a diagnostic code for hypothyroidism or hyperthyroidism, pulmonary embolism (PE), and deep venous thrombosis (DVT) was obtained from the National Hospital Discharge Survey (NHDS). Among 19,519,000 hospitalized patients discharged with a diagnosis of hypothyroidism from 1979 to 2005, 119,000 (0.61%) had PE. Among patients with no thyroid dysfunction, PE was diagnosed in 3,372,000 of 908,805,000 patients (0.37%; relative risk = 1.64, 95% CI 1.63-1.65). Deep venous thrombosis was diagnosed in 1.36% of hypothyroid patients and in 0.84% of patients with no thyroid dysfunction (relative risk = 1.62, 95% CI 1.61-1.62). The relative risk of PE in patients with hypothyroidism was highest in patients<40 years of age (relative risk = 3.99) and the relative risk of DVT was also highest in patients <40 years (relative risk = 2.25). Hyperthyroidism was not associated with an increased risk of VTE (relative risk = 0.98, 95% CI = 0.96-1.01). In conclusion, an increased risk of PE, DVT, and VTE was shown in patients with hypothyroidism but not hyperthyroidism. Antithrombotic prophylaxis in patients with severe hypothyroidism, however, should be viewed with caution because of a possible hyperfibrinolytic state in such patients.

The purpose of this study is to determine the incidence of venous thromboembolism (VTE) in patients with ulcerative colitis and patients with Crohn disease. The number of patients discharged from hospitals throughout the United States with a diagnostic code for ulcerative colitis and for Crohn disease from 1979 through 2005 was obtained from the National Hospital Discharge Survey. The incidence of VTE among medical patients with ulcerative colitis was 21 000 of 1 129 000 (1.85%) and among medical patients who had no inflammatory bowel disease, the incidence was 10 421 000 of 918 570 000 (1.13%; relative risk 1.64, 95% confidence interval [CI] = 1.62-1.66). The incidence of VTE among medical patients with Crohn disease was less than those with ulcerative colitis, 22 000 of 1 803 000 (1.22%). The risk, compared with patients who did not have inflammatory bowel disease, was only marginally increased (relative risk 1.08, 95% CI = 1.06-1.09).