Venous Thromboembolism in Nursing Home Residents: Role of Selected Risk Factors
Objectives To provide nursing home (NH)‐specific estimates to assess whether venous thromboembolism (VTE) risk factors identified for the general population apply to NH residents. Design Population‐based case–control study. Setting Olmsted County, Minnesota. Participants All county residents with sy...
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| Veröffentlicht in: | Journal of the American Geriatrics Society (JAGS) 2012-09, Vol.60 (9), p.1718-1723 |
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| creator | Leibson, Cynthia L. Petterson, Tanya M. Smith, Carin Y. Bailey, Kent R. Ashrani, Aneel A. Heit, John A. |
| description | Objectives
To provide nursing home (NH)‐specific estimates to assess whether venous thromboembolism (VTE) risk factors identified for the general population apply to NH residents.
Design
Population‐based case–control study.
Setting
Olmsted County, Minnesota.
Participants
All county residents with symptomatic objectively diagnosed incident VTE while resident in a NH from 1988 through 2000 (N = 182) and two age‐, sex‐, calendar‐year‐matched non‐VTE Olmsted County NH residents per case (N = 364).
Measurements
Provider‐linked medical records were reviewed to obtain information on active malignancy and recent hospitalization, surgery, trauma, or fracture as of index date (case's VTE date; respective provider registration date for controls). Risk factor prevalence and VTE‐associated odds ratios (OR) were estimated and compared with previously obtained data for all Olmsted County residents from 1988 through 2000. For analyses, both groups were limited to individuals aged 65 and older.
Results
In NH residents, active malignancy, recent hospitalization, and recent surgery significantly increased VTE risk, but the magnitude of risk appeared much lower than general population estimates (e.g., for major surgery, OR = 2.5, 95% confidence interval (CI) = 1.4–4.3 for NH residents vs OR = 11, 95% CI = 7.0–17 for general population). In general, the prevalence of all evaluated VTE risk factors appeared much higher in NH controls than in general population controls. Thromboprophylaxis rates appeared higher for NH cases and controls than in the general population; disconcertingly, 47% of NH cases received prophylaxis.
Conclusion
Although general population VTE risk factors (active cancer and recent hospitalization or surgery) can identify NH residents at higher risk for VTE, these exposures do not adequately stratify VTE risk for thromboprophylaxis recommendations. Further research into NH‐specific risk factors and prophylaxis effectiveness is required. |
| doi_str_mv | 10.1111/j.1532-5415.2012.04100.x |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1113234731</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1113234731</sourcerecordid><originalsourceid>FETCH-LOGICAL-c5480-ddf0efdb3779623956944c7eec47206a834862f58a40ab94400d69be84dd9a293</originalsourceid><addsrcrecordid>eNqNkV2L1DAUhoMo7rj6FyQggjetJx9NU8GLZXRn1GEXZtePu5BpT7WzbbMmLc7-e1NnHMEbDRwSOM-b8_ESQhmkLJ6X25RlgieZZFnKgfEUJANId_fI7Ji4T2YAwBOtmDwhj0LYQiRB64fkhHOtQXE1I5efsHdjoNffvOs2DmO0Teho09OL0Yem_0qXrkO6xtBU2A_hFV27Fqmr6RW2WA5Y0XUTbui5LQfnw2PyoLZtwCeH-5R8PH97PV8mq8vFu_nZKikzqSGpqhqwrjYizwvFRZGpQsoyRyxlzkFZLaRWvM60lWA3MQdQqWKDWlZVYXkhTsmL_b-33n0fMQyma0KJbWt7jPOYuCXBhcwF-zcal8ckiEJE9Nlf6NaNvo-DTBSogmulIqX3VOldCB5rc-ubzvq7CE2FmdmayQYz2WAmf8wvf8wuSp8eCoybDquj8LchEXh-AGwobVt725dN-MMpKZWCiXu95340Ld79dwPm_eJqekV9stc3YcDdUW_9jVG5yDPz-WJhVvMvy8WbJTMfxE_M1bdU</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1040692866</pqid></control><display><type>article</type><title>Venous Thromboembolism in Nursing Home Residents: Role of Selected Risk Factors</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><creator>Leibson, Cynthia L. ; Petterson, Tanya M. ; Smith, Carin Y. ; Bailey, Kent R. ; Ashrani, Aneel A. ; Heit, John A.</creator><creatorcontrib>Leibson, Cynthia L. ; Petterson, Tanya M. ; Smith, Carin Y. ; Bailey, Kent R. ; Ashrani, Aneel A. ; Heit, John A.</creatorcontrib><description>Objectives
To provide nursing home (NH)‐specific estimates to assess whether venous thromboembolism (VTE) risk factors identified for the general population apply to NH residents.
Design
Population‐based case–control study.
Setting
Olmsted County, Minnesota.
Participants
All county residents with symptomatic objectively diagnosed incident VTE while resident in a NH from 1988 through 2000 (N = 182) and two age‐, sex‐, calendar‐year‐matched non‐VTE Olmsted County NH residents per case (N = 364).
Measurements
Provider‐linked medical records were reviewed to obtain information on active malignancy and recent hospitalization, surgery, trauma, or fracture as of index date (case's VTE date; respective provider registration date for controls). Risk factor prevalence and VTE‐associated odds ratios (OR) were estimated and compared with previously obtained data for all Olmsted County residents from 1988 through 2000. For analyses, both groups were limited to individuals aged 65 and older.
Results
In NH residents, active malignancy, recent hospitalization, and recent surgery significantly increased VTE risk, but the magnitude of risk appeared much lower than general population estimates (e.g., for major surgery, OR = 2.5, 95% confidence interval (CI) = 1.4–4.3 for NH residents vs OR = 11, 95% CI = 7.0–17 for general population). In general, the prevalence of all evaluated VTE risk factors appeared much higher in NH controls than in general population controls. Thromboprophylaxis rates appeared higher for NH cases and controls than in the general population; disconcertingly, 47% of NH cases received prophylaxis.
Conclusion
Although general population VTE risk factors (active cancer and recent hospitalization or surgery) can identify NH residents at higher risk for VTE, these exposures do not adequately stratify VTE risk for thromboprophylaxis recommendations. Further research into NH‐specific risk factors and prophylaxis effectiveness is required.</description><identifier>ISSN: 0002-8614</identifier><identifier>EISSN: 1532-5415</identifier><identifier>DOI: 10.1111/j.1532-5415.2012.04100.x</identifier><identifier>PMID: 22880626</identifier><identifier>CODEN: JAGSAF</identifier><language>eng</language><publisher>Hoboken, NJ: Blackwell Publishing Ltd</publisher><subject>Aged ; Aged, 80 and over ; Biological and medical sciences ; Blood and lymphatic vessels ; Cancer ; Cardiology. Vascular system ; Case-Control Studies ; deep vein thrombosis ; Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous ; Female ; General aspects ; Humans ; Logistic Models ; long-term care ; Male ; Medical sciences ; Minnesota - epidemiology ; nursing home ; Nursing Homes ; Pneumology ; Population control ; Prevalence ; pulmonary embolism ; Pulmonary hypertension. Acute cor pulmonale. Pulmonary embolism. Pulmonary vascular diseases ; Retrospective Studies ; Reviews ; Risk Factors ; Surgery ; thromboembolism ; Thrombosis ; Vein & artery diseases ; venous thromboembolism ; Venous Thromboembolism - epidemiology</subject><ispartof>Journal of the American Geriatrics Society (JAGS), 2012-09, Vol.60 (9), p.1718-1723</ispartof><rights>2012, Copyright the Authors Journal compilation © 2012, The American Geriatrics Society</rights><rights>2015 INIST-CNRS</rights><rights>2012, Copyright the Authors Journal compilation © 2012, The American Geriatrics Society.</rights><rights>2012 American Geriatrics Society and Wiley Periodicals, Inc</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5480-ddf0efdb3779623956944c7eec47206a834862f58a40ab94400d69be84dd9a293</citedby><cites>FETCH-LOGICAL-c5480-ddf0efdb3779623956944c7eec47206a834862f58a40ab94400d69be84dd9a293</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fj.1532-5415.2012.04100.x$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fj.1532-5415.2012.04100.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=26446606$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22880626$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Leibson, Cynthia L.</creatorcontrib><creatorcontrib>Petterson, Tanya M.</creatorcontrib><creatorcontrib>Smith, Carin Y.</creatorcontrib><creatorcontrib>Bailey, Kent R.</creatorcontrib><creatorcontrib>Ashrani, Aneel A.</creatorcontrib><creatorcontrib>Heit, John A.</creatorcontrib><title>Venous Thromboembolism in Nursing Home Residents: Role of Selected Risk Factors</title><title>Journal of the American Geriatrics Society (JAGS)</title><addtitle>J Am Geriatr Soc</addtitle><description>Objectives
To provide nursing home (NH)‐specific estimates to assess whether venous thromboembolism (VTE) risk factors identified for the general population apply to NH residents.
Design
Population‐based case–control study.
Setting
Olmsted County, Minnesota.
Participants
All county residents with symptomatic objectively diagnosed incident VTE while resident in a NH from 1988 through 2000 (N = 182) and two age‐, sex‐, calendar‐year‐matched non‐VTE Olmsted County NH residents per case (N = 364).
Measurements
Provider‐linked medical records were reviewed to obtain information on active malignancy and recent hospitalization, surgery, trauma, or fracture as of index date (case's VTE date; respective provider registration date for controls). Risk factor prevalence and VTE‐associated odds ratios (OR) were estimated and compared with previously obtained data for all Olmsted County residents from 1988 through 2000. For analyses, both groups were limited to individuals aged 65 and older.
Results
In NH residents, active malignancy, recent hospitalization, and recent surgery significantly increased VTE risk, but the magnitude of risk appeared much lower than general population estimates (e.g., for major surgery, OR = 2.5, 95% confidence interval (CI) = 1.4–4.3 for NH residents vs OR = 11, 95% CI = 7.0–17 for general population). In general, the prevalence of all evaluated VTE risk factors appeared much higher in NH controls than in general population controls. Thromboprophylaxis rates appeared higher for NH cases and controls than in the general population; disconcertingly, 47% of NH cases received prophylaxis.
Conclusion
Although general population VTE risk factors (active cancer and recent hospitalization or surgery) can identify NH residents at higher risk for VTE, these exposures do not adequately stratify VTE risk for thromboprophylaxis recommendations. Further research into NH‐specific risk factors and prophylaxis effectiveness is required.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Biological and medical sciences</subject><subject>Blood and lymphatic vessels</subject><subject>Cancer</subject><subject>Cardiology. Vascular system</subject><subject>Case-Control Studies</subject><subject>deep vein thrombosis</subject><subject>Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous</subject><subject>Female</subject><subject>General aspects</subject><subject>Humans</subject><subject>Logistic Models</subject><subject>long-term care</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Minnesota - epidemiology</subject><subject>nursing home</subject><subject>Nursing Homes</subject><subject>Pneumology</subject><subject>Population control</subject><subject>Prevalence</subject><subject>pulmonary embolism</subject><subject>Pulmonary hypertension. Acute cor pulmonale. Pulmonary embolism. Pulmonary vascular diseases</subject><subject>Retrospective Studies</subject><subject>Reviews</subject><subject>Risk Factors</subject><subject>Surgery</subject><subject>thromboembolism</subject><subject>Thrombosis</subject><subject>Vein & artery diseases</subject><subject>venous thromboembolism</subject><subject>Venous Thromboembolism - epidemiology</subject><issn>0002-8614</issn><issn>1532-5415</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkV2L1DAUhoMo7rj6FyQggjetJx9NU8GLZXRn1GEXZtePu5BpT7WzbbMmLc7-e1NnHMEbDRwSOM-b8_ESQhmkLJ6X25RlgieZZFnKgfEUJANId_fI7Ji4T2YAwBOtmDwhj0LYQiRB64fkhHOtQXE1I5efsHdjoNffvOs2DmO0Teho09OL0Yem_0qXrkO6xtBU2A_hFV27Fqmr6RW2WA5Y0XUTbui5LQfnw2PyoLZtwCeH-5R8PH97PV8mq8vFu_nZKikzqSGpqhqwrjYizwvFRZGpQsoyRyxlzkFZLaRWvM60lWA3MQdQqWKDWlZVYXkhTsmL_b-33n0fMQyma0KJbWt7jPOYuCXBhcwF-zcal8ckiEJE9Nlf6NaNvo-DTBSogmulIqX3VOldCB5rc-ubzvq7CE2FmdmayQYz2WAmf8wvf8wuSp8eCoybDquj8LchEXh-AGwobVt725dN-MMpKZWCiXu95340Ld79dwPm_eJqekV9stc3YcDdUW_9jVG5yDPz-WJhVvMvy8WbJTMfxE_M1bdU</recordid><startdate>201209</startdate><enddate>201209</enddate><creator>Leibson, Cynthia L.</creator><creator>Petterson, Tanya M.</creator><creator>Smith, Carin Y.</creator><creator>Bailey, Kent R.</creator><creator>Ashrani, Aneel A.</creator><creator>Heit, John A.</creator><general>Blackwell Publishing Ltd</general><general>Wiley-Blackwell</general><general>Wiley Subscription Services, Inc</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>7TK</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><scope>7U1</scope><scope>7U2</scope><scope>C1K</scope></search><sort><creationdate>201209</creationdate><title>Venous Thromboembolism in Nursing Home Residents: Role of Selected Risk Factors</title><author>Leibson, Cynthia L. ; Petterson, Tanya M. ; Smith, Carin Y. ; Bailey, Kent R. ; Ashrani, Aneel A. ; Heit, John A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5480-ddf0efdb3779623956944c7eec47206a834862f58a40ab94400d69be84dd9a293</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Biological and medical sciences</topic><topic>Blood and lymphatic vessels</topic><topic>Cancer</topic><topic>Cardiology. Vascular system</topic><topic>Case-Control Studies</topic><topic>deep vein thrombosis</topic><topic>Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous</topic><topic>Female</topic><topic>General aspects</topic><topic>Humans</topic><topic>Logistic Models</topic><topic>long-term care</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Minnesota - epidemiology</topic><topic>nursing home</topic><topic>Nursing Homes</topic><topic>Pneumology</topic><topic>Population control</topic><topic>Prevalence</topic><topic>pulmonary embolism</topic><topic>Pulmonary hypertension. Acute cor pulmonale. Pulmonary embolism. Pulmonary vascular diseases</topic><topic>Retrospective Studies</topic><topic>Reviews</topic><topic>Risk Factors</topic><topic>Surgery</topic><topic>thromboembolism</topic><topic>Thrombosis</topic><topic>Vein & artery diseases</topic><topic>venous thromboembolism</topic><topic>Venous Thromboembolism - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Leibson, Cynthia L.</creatorcontrib><creatorcontrib>Petterson, Tanya M.</creatorcontrib><creatorcontrib>Smith, Carin Y.</creatorcontrib><creatorcontrib>Bailey, Kent R.</creatorcontrib><creatorcontrib>Ashrani, Aneel A.</creatorcontrib><creatorcontrib>Heit, John A.</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><collection>Risk Abstracts</collection><collection>Safety Science and Risk</collection><collection>Environmental Sciences and Pollution Management</collection><jtitle>Journal of the American Geriatrics Society (JAGS)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Leibson, Cynthia L.</au><au>Petterson, Tanya M.</au><au>Smith, Carin Y.</au><au>Bailey, Kent R.</au><au>Ashrani, Aneel A.</au><au>Heit, John A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Venous Thromboembolism in Nursing Home Residents: Role of Selected Risk Factors</atitle><jtitle>Journal of the American Geriatrics Society (JAGS)</jtitle><addtitle>J Am Geriatr Soc</addtitle><date>2012-09</date><risdate>2012</risdate><volume>60</volume><issue>9</issue><spage>1718</spage><epage>1723</epage><pages>1718-1723</pages><issn>0002-8614</issn><eissn>1532-5415</eissn><coden>JAGSAF</coden><abstract>Objectives
To provide nursing home (NH)‐specific estimates to assess whether venous thromboembolism (VTE) risk factors identified for the general population apply to NH residents.
Design
Population‐based case–control study.
Setting
Olmsted County, Minnesota.
Participants
All county residents with symptomatic objectively diagnosed incident VTE while resident in a NH from 1988 through 2000 (N = 182) and two age‐, sex‐, calendar‐year‐matched non‐VTE Olmsted County NH residents per case (N = 364).
Measurements
Provider‐linked medical records were reviewed to obtain information on active malignancy and recent hospitalization, surgery, trauma, or fracture as of index date (case's VTE date; respective provider registration date for controls). Risk factor prevalence and VTE‐associated odds ratios (OR) were estimated and compared with previously obtained data for all Olmsted County residents from 1988 through 2000. For analyses, both groups were limited to individuals aged 65 and older.
Results
In NH residents, active malignancy, recent hospitalization, and recent surgery significantly increased VTE risk, but the magnitude of risk appeared much lower than general population estimates (e.g., for major surgery, OR = 2.5, 95% confidence interval (CI) = 1.4–4.3 for NH residents vs OR = 11, 95% CI = 7.0–17 for general population). In general, the prevalence of all evaluated VTE risk factors appeared much higher in NH controls than in general population controls. Thromboprophylaxis rates appeared higher for NH cases and controls than in the general population; disconcertingly, 47% of NH cases received prophylaxis.
Conclusion
Although general population VTE risk factors (active cancer and recent hospitalization or surgery) can identify NH residents at higher risk for VTE, these exposures do not adequately stratify VTE risk for thromboprophylaxis recommendations. Further research into NH‐specific risk factors and prophylaxis effectiveness is required.</abstract><cop>Hoboken, NJ</cop><pub>Blackwell Publishing Ltd</pub><pmid>22880626</pmid><doi>10.1111/j.1532-5415.2012.04100.x</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0002-8614 |
| ispartof | Journal of the American Geriatrics Society (JAGS), 2012-09, Vol.60 (9), p.1718-1723 |
| issn | 0002-8614 1532-5415 |
| language | eng |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Aged Aged, 80 and over Biological and medical sciences Blood and lymphatic vessels Cancer Cardiology. Vascular system Case-Control Studies deep vein thrombosis Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous Female General aspects Humans Logistic Models long-term care Male Medical sciences Minnesota - epidemiology nursing home Nursing Homes Pneumology Population control Prevalence pulmonary embolism Pulmonary hypertension. Acute cor pulmonale. Pulmonary embolism. Pulmonary vascular diseases Retrospective Studies Reviews Risk Factors Surgery thromboembolism Thrombosis Vein & artery diseases venous thromboembolism Venous Thromboembolism - epidemiology |
| title | Venous Thromboembolism in Nursing Home Residents: Role of Selected Risk Factors |
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