Clinical Investigation
Diabetes Mellitus and Risk of Venous Thromboembolism

https://doi.org/10.1097/MAJ.0b013e31818bbb8bGet rights and content

Abstract

Background

To determine if diabetes mellitus is a risk factor for venous thromboembolism (VTE).

Research Design and Methods

Data from the National Hospital Discharge Survey were analyzed from 1979 to 2005. International Classification of Diseases, Ninth Revision, Clinical Modification codes were used to identify diseases.

Results

Among 92,240,000 patients with diabetes mellitus discharged between 1979 and 2005, 1,267,000 (1.4%) had VTE. The relative risk for VTE was elevated only in patients younger than 50 to 59 years and was highest in patients aged 20 to 29 years (relative risk = 1.73). Relative risks of VTE with uncomplicated type 1 diabetes mellitus and uncomplicated type 2 diabetes mellitus were similar and also age dependent. In patients with uncomplicated diabetes mellitus who did not have obesity, stroke, heart failure, or cancer, compared with those who did not have diabetes mellitus and did not have any of these comorbid conditions, the relative risk for VTE was 1.52 in patients aged 20 to 29 years and 1.19 in patients aged 30 to 39 years. In older patients, the relative risk of VTE in patients with diabetes mellitus was not increased.

Conclusions

Diabetes mellitus carries an increased risk for VTE, which is apparent only in younger patients in whom comorbid conditions that also increase the risk of VTE are unlikely to be present.

Section snippets

Data Sources

The number of patients discharged from short-stay nonfederal hospitals throughout the United States with a diagnostic code for diabetes mellitus from 1979 to 2005 was obtained from the NHDS.14 Among these patients the number with pulmonary embolism, deep venous thrombosis, or the combination of pulmonary embolism and/or deep venous thrombosis (VTE) was determined. The NHDS consists of data obtained annually from approximately 270,000 sampled inpatient records from about 500 nonfederal

RESULTS

During the 27 years of study, among 92,240,000 patients discharged from short-stay hospitals from 1979 to 2005 with diabetes mellitus, VTE was diagnosed in 1,267,000 patients (1.4%) (Table 1). Among 699,858,000 patients who did not have diabetes mellitus, the incidence was similar, 1.3% (Table 1). The incidence of pulmonary embolism, deep venous thrombosis, and VTE in patients with diabetes mellitus increased to age 80 years just as it increased in patients who did not have diabetes mellitus (

DISCUSSION

Among all hospitalized patients, the incidence of VTE increased with age until 80 years. Patients with diabetes mellitus were not an exception to this; an age-related increased incidence of VTE in patients with diabetes mellitus was shown. However, the relative risk for VTE (comparing patients with diabetes mellitus to those who did not have diabetes mellitus) decreased with age until 70 years. In patients with uncomplicated diabetes mellitus who did not have stroke, heart failure, cancer, or

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