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Active TB increased VTE risk
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Adults with active tuberculosis had a greater risk for venous thromboembolism than those without, according to recent data.
Severe and acute infections are a known risk factor for venous thromboembolism (VTE) and precede 52% of hospitalized VTE cases, researchers from Centre Hospitalier Universitaire de Grenoble in France wrote in Clinical Infectious Diseases.
“Active TB appears as another significant risk factor, comparable to the risk of VTE posed by cancer,” they wrote. “We recommend that physicians should bear in mind the possibility of VTE when they follow patients with TB, and that they should include TB in their evaluation of thromboembolism risk.”
The researchers used data from the Premier Perspective database, which uses ICD-9 codes, to evaluate the VTE risk associated with TB. They identified 27,659,947 hospital admissions from 2006. Among those, 199,552 had a VTE diagnosis and 3,485 cases of active TB.
Seventy-two patients with VTE had coexisting TB: 59 had pulmonary TB, 13 had extrapulmonary TB and two had both. The prevalence of VTE among patients with active TB was 2.07% compared with 0.72% among patients without active TB. In a multivariate analysis, TB was significantly associated with VTE (OR=1.55; 95% CI, 1.23-1.97). Other risk factors with lower ORs included male sex, increasing age and heparin-based prophylaxis.
“As expected, the classical VTE risk factors were associated with VTE, and the risk rose steadily as the number of risk factors increased,” the researchers wrote. “Surprisingly, heparin-based prophylaxis was found to be statistically significantly associated with VTE, probably reflecting an indication bias.”
In-hospital mortality among patients with both VTE and TB was higher than mortality among patients with only VTE or only TB. Among patients with TB, VTE was independently associated with mortality (OR=3.87; 95% CI, 1.86-8.07).
Disclosure: The researchers report no relevant financial disclosures.
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