Active Tuberculosis and Venous Thromboembolism: Association According to International Classification of Diseases, Ninth Revision Hospital Discharge Diagnosis Codes
Open Access
- 26 November 2013
- journal article
- research article
- Published by Oxford University Press (OUP) in Clinical Infectious Diseases
- Vol. 58 (4), 495-501
- https://doi.org/10.1093/cid/cit780
Abstract
Background. Infections are risk factors for venous thromboembolism (VTE), especially if severe and acute. The role of chronic infections such as active tuberculosis is ill defined, although several case reports and small series have suggested an association between tuberculosis and VTE. Methods. Using data from the Premier Perspective database (27 659 947 admissions), we performed a multivariate analysis to assess the specific VTE risk associated with tuberculosis. The analysis was adjusted on classic risk factors for VTE. Results. The prevalence of VTE among patients with active tuberculosis was 2.07% (95% confidence interval [CI], 1.62%–2.59%). In a multivariate analysis model, adults with active tuberculosis had a greater risk of VTE than those without (odds ratio, 1.55 [95% CI, 1.23–1.97], P < .001), close to the previously reported risk associated with neoplasia. No particular link was found between pulmonary tuberculosis and pulmonary embolism, or between extrapulmonary tuberculosis and deep vein thrombosis. This may suggest the preponderant role of a systemic hypercoagulable state over an intrathoracic venous compression mechanism. In-hospital mortality of patients with both active tuberculosis and VTE (11/72 [15%]) was higher than mortality of patients with only active tuberculosis (92/3413 [2.7%]) or only VTE (5062/199 480 [2.5%]) (P < .001). Pulmonary embolism was more frequent in black patients, suggesting that this population, which is also more likely to suffer from tuberculosis, should be followed carefully. Conclusions. Tuberculosis must be considered as a pertinent risk factor for VTE and should be included in thromboembolism risk evaluation similar to any acute and severe infection.Keywords
This publication has 33 references indexed in Scilit:
- Mycobacterium tuberculosis Infection and Tissue Factor Expression in MacrophagesPLOS ONE, 2012
- Triggers of Hospitalization for Venous ThromboembolismCirculation, 2012
- Accuracy of pharmacy and coded-diagnosis information in identifying tuberculosis in patients with rheumatoid arthritisPharmacoepidemiology and Drug Safety, 2012
- Prevention of VTE in Nonsurgical Patients: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice GuidelinesSocial psychiatry. Sozialpsychiatrie. Psychiatrie sociale, 2012
- Acute infections and venous thromboembolismJournal of Internal Medicine, 2011
- Racial Differences in Tuberculosis Infection in United States Communities: The Coronary Artery Risk Development in Young Adults StudyClinical Infectious Diseases, 2011
- Venous thromboembolism risk and prophylaxis in hospitalised medically ill patientsThrombosis and Haemostasis, 2010
- Tuberculosis and Venous Thromboembolism: a case seriesCases Journal, 2009
- Adapting a clinical comorbidity index for use with ICD-9-CM administrative databasesJournal of Clinical Epidemiology, 1992
- A new method of classifying prognostic comorbidity in longitudinal studies: Development and validationJournal of Chronic Diseases, 1987