Diabetes Mellitus and Risk of Venous Thromboembolism

Stein, Paul D.; Goldman, Jack A.; Matta, Fadi; Yaekoub, Abdo Y.

doi:10.1097/maj.0b013e31818bbb8b

Cited by 66 publications

(57 citation statements)

References 20 publications

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“…Also, there is evidence of activation of the extrinsic coagulation cascade in the asthmatic airway, with involvement of both plasma and locally derived factors [7,8]. This is supported by a recent finding showing local vascular inflammation in asthma and COPD [30], as well as the observation of a higher incidence of PE than DVT in COPD patients [22], and evidence that in other chronic inflammatory disorders, such as diabetes, rheumatoid arthritis and ulcerative colitis, a higher incidence of PE has not been observed [3][4][5]. Taken together, the results of the present study suggest that, particularly in severe asthma, the balance between coagulation and fibrinolysis is seriously disturbed.…”

Section: Discussionsupporting

confidence: 71%

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Risk of deep vein thrombosis and pulmonary embolism in asthma

Majoor

Kamphuisen

Zwinderman³

et al. 2012

Eur Respir J

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Increasing evidence suggests that patients with asthma have activated coagulation within the airways. Whether this leads to an increase in venous thromboembolic events is unknown. We therefore assessed the incidence of venous thromboembolic events in patients with mild-to-moderate and severe asthma as compared with an age-and sex-matched reference population.648 patients with asthma (283 with severe and 365 patients with mild-to-moderate asthma) visiting three Dutch outpatient asthma clinics were studied. All patients completed a questionnaire about a diagnosis of deep vein thrombosis and pulmonary embolism in the past, their risk factors, history of asthma and medication use. All venous thromboembolic events were objectively verified.In total, 35 venous thromboembolic events (16 deep vein thrombosis and 19 pulmonary embolism) occurred at a median age of 39 (range 20-63) years. The incidence of pulmonary embolism in patients with severe asthma was 0.93 (95% CI 0.42-1.44) per 1000 person-years, 0.33 (95% CI 0.07-0.60) in mild-tomoderate asthma and 0.18 (95% CI 0.03-0.33) in the general population, respectively. Severe asthma and oral corticosteroid use were independent risk factors of pulmonary embolism (hazard ratios 3.33 (1.16-9.93) and 2.82 (1.09-7.30), respectively). Asthma was not associated with deep vein thrombosis.Severe asthma greatly enhances the risk of pulmonary embolism, particularly if chronic corticosteroids are used. @ERSpublications Severe asthma greatly enhances the risk of pulmonary embolism, particularly if chronic corticosteroids are used

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Section: Discussionsupporting

confidence: 71%

“…This has been shown for inflammatory bowel disease [3], rheumatoid arthritis [4], diabetes mellitus [5] and chronic obstructive pulmonary disease (COPD) [6]. Asthma has also been associated with a procoagulant and antifibrinolytic activity in the airways [7,8].…”

Section: Introductionmentioning

confidence: 99%

Risk of deep vein thrombosis and pulmonary embolism in asthma

Majoor

Kamphuisen

Zwinderman³

et al. 2012

Eur Respir J

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“…Furthermore, the rate of VTE was higher in patients undergoing knee TJA compared to hip TJA. Increasing rates of VTE have been noted in obese and diabetic patients, potentially due to alterations in hemostasis pathways (19)(20)(21)(22). In this present study, obesity and diabetes mellitus were overrepresented in the knee TJA cohort, which may have accounted for the increased incidence of VTE.…”

Section: Discussionmentioning

confidence: 99%

Direct Hospital Cost Determinants Following Hip and Knee Arthroplasty

Peel

Cheng

Liew

et al. 2015

Arthritis Care & Research

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Objective. Total joint arthroplasty (TJA) places a significant economic burden on health care resources. This cohort study examines the costs associated with arthroplasty in 827 patients undergoing hip and knee TJA from January 2011 to June 2012 at a single center in Melbourne, Australia. Methods. Data included total inpatient, outpatient, and readmissions costs in the 30 days following TJA. Factors associated with cost were modeled using negative binomial regression and extrapolated to the Australian population. Results. The base cost (i.e., the cost for a patient with no modifying factors) over the first 30 days following TJA was $13,060 Australian (AU) (interquartile range $12,126-14,067 AU). The median length of stay was 4 days (range 2-33 days) and 35 patients (4%) were readmitted in the first 30 days following index TJA, the majority of whom had a surgical site infection (SSI) (74%). The following factors were independently associated with increased costs: SSI, preoperative warfarin therapy, American Society of Anesthesiologists score of 3 or 4, hip TJA, increasing operation time, increasing postoperative blood transfusion requirements, other nosocomial infections, postoperative venous thromboembolism (VTE), pressure ulcers, postoperative confusion, and acute urinary retention. Based on data from the present study, the cost of TJA in Australia is estimated to exceed $1 billion AU per year. Preventable postoperative complications were major cost drivers: SSI and VTE added a further $97 million AU and $66 million AU, respectively, to arthroplasty costs in the first 30 days following surgery. Conclusion. This unique study has identified important factors influencing TJA costs and providing guidance for future research and resource allocation.

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“…Furthermore, the increased incidence of VTE in patients with risk factors for arterial cardiovascular events points too to a common pathogenesis (6). Indeed, a number of studies, with different design and in various clinical settings, have shown an increased risk of VTE associated with most of the classic or novel risk factor for ischaemic cardiovascular disease (7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22) (ǠTable 1).…”

Section: The Association Between Venous and Arterial Thrombosismentioning

confidence: 99%

Endothelium, venous thromboembolism and ischaemic cardiovascular events

Gresele

Momi

Migliacci³

2010

Thromb Haemost

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SummaryThe association between venous thromboembolism and arterial thrombosis has emerged as consistent clinical observation in the last few years. While several experimental, epidemiological and pharmacologic studies support this association, the initial pathophysiological mechanism linking these two clinical conditions remains to be established. This review discusses the pathophysiological bases and a number of ex- perimental and clinical observations suggesting that the common link between venous thromboembolism and arterial thrombosis is represented by a dysfunctional endothelium.

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Diabetes Mellitus and Risk of Venous Thromboembolism

Cited by 66 publications

References 20 publications

Risk of deep vein thrombosis and pulmonary embolism in asthma

Risk of deep vein thrombosis and pulmonary embolism in asthma

Direct Hospital Cost Determinants Following Hip and Knee Arthroplasty

Endothelium, venous thromboembolism and ischaemic cardiovascular events

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