Thromb Haemost 2020; 120(03): 477-483
DOI: 10.1055/s-0039-3400744
Stroke, Systemic or Venous Thromboembolism
Georg Thieme Verlag KG Stuttgart · New York

Chronic Obstructive Pulmonary Disease and Risk of Mortality in Patients with Venous Thromboembolism—The Tromsø Study

Trond Børvik
1  K.G. Jebsen Thrombosis Research and Expertise Center (TREC), Department of Clinical Medicine, UiT-The Arctic University of Norway, Tromsø, Norway
2  Division of Internal Medicine, University Hospital of North Norway, Tromsø, Norway
,
Sigrid K. Brækkan
1  K.G. Jebsen Thrombosis Research and Expertise Center (TREC), Department of Clinical Medicine, UiT-The Arctic University of Norway, Tromsø, Norway
2  Division of Internal Medicine, University Hospital of North Norway, Tromsø, Norway
,
Line H. Evensen
1  K.G. Jebsen Thrombosis Research and Expertise Center (TREC), Department of Clinical Medicine, UiT-The Arctic University of Norway, Tromsø, Norway
2  Division of Internal Medicine, University Hospital of North Norway, Tromsø, Norway
,
Ellen E. Brodin
1  K.G. Jebsen Thrombosis Research and Expertise Center (TREC), Department of Clinical Medicine, UiT-The Arctic University of Norway, Tromsø, Norway
3  Division of Internal Medicine, Department of Haematology, Akershus University Hospital, Lørenskog, Norway
,
Vania M. Morelli
1  K.G. Jebsen Thrombosis Research and Expertise Center (TREC), Department of Clinical Medicine, UiT-The Arctic University of Norway, Tromsø, Norway
2  Division of Internal Medicine, University Hospital of North Norway, Tromsø, Norway
,
Hasse Melbye
4  Department of Community Medicine, UiT – The Arctic University of Norway, Tromsø, Norway
,
John-Bjarne Hansen
1  K.G. Jebsen Thrombosis Research and Expertise Center (TREC), Department of Clinical Medicine, UiT-The Arctic University of Norway, Tromsø, Norway
2  Division of Internal Medicine, University Hospital of North Norway, Tromsø, Norway
› Author Affiliations
Funding K.G. Jebsen TREC is supported by an independent grant from Stiftelsen Kristian Gerhard Jebsen.
Further Information

Publication History

03 June 2019

19 October 2019

Publication Date:
30 December 2019 (online)

Abstract

Background Previous studies have shown increased mortality in venous thromboembolism (VTE) patients with chronic obstructive pulmonary disease (COPD), but it is unknown to what extent the association is influenced by the severity of COPD and physical inactivity.

Objectives This article investigates whether COPD, and stages of COPD, influenced the risk of mortality after a first episode of VTE when physical inactivity was taken into account.

Methods Patients with a first lifetime VTE (n = 256) were recruited among individuals who participated and performed spirometry in the fifth (2001–2002) and sixth (2007–2008) surveys of the Tromsø Study (n = 9577). All-cause mortality was registered up to December 31, 2015.

Results There were 123 deaths during a median of 2.9 years of follow-up. The overall mortality rate was 11.9 (95% confidence interval [CI] 10.0–14.2) per 100 person-years. The risk of death was twofold higher in COPD patients compared with those with normal airflow (hazard ratio [HR] 2.00, 95% CI 1.30–3.08) after multivariable adjustment. The risk of death increased with the severity of COPD. VTE patients with COPD stage III/IV had a fivefold increased risk of death (HR 5.20, 95% CI 2.65–10.2) compared with those without COPD, and 50% of these patients died within 3.5 months after the incident VTE event. Adjustment for physical inactivity had minor effect on the risk estimates.

Conclusion VTE patients with COPD had increased risk of death, particularly patients with severe COPD. The detrimental effect of COPD on mortality in VTE patients was apparently explained by factors other than physical inactivity among patients with COPD.

Authors' Contributions

Conception and design: J.B.H. Data collection: T.B., S.K.B., H.M., J.B.H. Statistical analyses: T.B., S.K.B., L.E. Draft of manuscript: T.B., J.B.H. Interpretation of results: T.B., L.E., W.M.M., E.B.B., H.M., S.K.B., J.B.H. Critical revision of the manuscript: L.E., W.M.M., E.B.B., H.M., S.K.B., J.B.H.


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