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Risk of pulmonary embolism in patients with autoimmune disorders: a nationwide follow-up study from Sweden.

Zöller, Bengt LU ; Li, Xinjun LU ; Sundquist, Jan LU and Sundquist, Kristina LU (2012) In The Lancet 379. p.244-249
Abstract
BACKGROUND: Some autoimmune disorders have been linked to venous thromboembolism. We examined whether there is an association between autoimmune disorders and risk of pulmonary embolism. METHODS: We followed up all individuals in Sweden without previous hospital admission for venous thromboembolism and with a primary or secondary diagnosis of an autoimmune disorder between Jan 1, 1964, and Dec 31, 2008, for hospital admission for pulmonary embolism. We obtained data from the MigMed2 database, which has individual-level information about all registered residents of Sweden. The reference population was the total population of Sweden. We calculated standardised incidence ratios (SIRs) for pulmonary embolism, adjusted for individual variables,... (More)
BACKGROUND: Some autoimmune disorders have been linked to venous thromboembolism. We examined whether there is an association between autoimmune disorders and risk of pulmonary embolism. METHODS: We followed up all individuals in Sweden without previous hospital admission for venous thromboembolism and with a primary or secondary diagnosis of an autoimmune disorder between Jan 1, 1964, and Dec 31, 2008, for hospital admission for pulmonary embolism. We obtained data from the MigMed2 database, which has individual-level information about all registered residents of Sweden. The reference population was the total population of Sweden. We calculated standardised incidence ratios (SIRs) for pulmonary embolism, adjusted for individual variables, including age and sex. FINDINGS: 535 538 individuals were admitted to hospital because of an autoimmune disorder. Overall risk of pulmonary embolism during the first year after admission for an autoimmune disorder was 6·38 (95% CI 6·19-6·57). All the 33 autoimmune disorders were associated with a significantly increased risk of pulmonary embolism during the first year after admission. However, some had a particularly high risk-eg, immune thrombocytopenic purpura (10·79, 95% CI 7·98-14·28), polyarteritis nodosa (13·26, 9·33-18·29), polymyositis or dermatomyositis (16·44, 11·57-22·69), and systemic lupus erythematosus (10·23, 8·31-12·45). Overall risk decreased over time, from 1·53 (1·48-1·57) at 1-5 years, to 1·15 (1·11-1·20) at 5-10 years, and 1·04 (1·00-1·07) at 10 years and later. The risk was increased for both sexes and all age groups. INTERPRETATION: Autoimmune disorders are associated with a high risk of pulmonary embolism in the first year after hospital admission. Our findings suggest that these disorders in general should be regarded as hypercoagulable disorders. FUNDING: Swedish Research Council, Swedish Council for Working Life and Social Research, Swedish Research Council Formas, Region Skåne. (Less)
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author
organization
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publication status
published
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in
The Lancet
volume
379
pages
244 - 249
publisher
Elsevier Limited
external identifiers
  • wos:000299316100039
  • pmid:22119579
  • scopus:84856095858
ISSN
1474-547X
DOI
10.1016/S0140-6736(11)61306-8
language
English
LU publication?
yes
id
62f5519c-d4b2-467c-8c56-0e4b9f368326 (old id 2220295)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/22119579?dopt=Abstract
date added to LUP
2011-12-03 10:23:26
date last changed
2017-10-22 04:52:05
@article{62f5519c-d4b2-467c-8c56-0e4b9f368326,
  abstract     = {BACKGROUND: Some autoimmune disorders have been linked to venous thromboembolism. We examined whether there is an association between autoimmune disorders and risk of pulmonary embolism. METHODS: We followed up all individuals in Sweden without previous hospital admission for venous thromboembolism and with a primary or secondary diagnosis of an autoimmune disorder between Jan 1, 1964, and Dec 31, 2008, for hospital admission for pulmonary embolism. We obtained data from the MigMed2 database, which has individual-level information about all registered residents of Sweden. The reference population was the total population of Sweden. We calculated standardised incidence ratios (SIRs) for pulmonary embolism, adjusted for individual variables, including age and sex. FINDINGS: 535 538 individuals were admitted to hospital because of an autoimmune disorder. Overall risk of pulmonary embolism during the first year after admission for an autoimmune disorder was 6·38 (95% CI 6·19-6·57). All the 33 autoimmune disorders were associated with a significantly increased risk of pulmonary embolism during the first year after admission. However, some had a particularly high risk-eg, immune thrombocytopenic purpura (10·79, 95% CI 7·98-14·28), polyarteritis nodosa (13·26, 9·33-18·29), polymyositis or dermatomyositis (16·44, 11·57-22·69), and systemic lupus erythematosus (10·23, 8·31-12·45). Overall risk decreased over time, from 1·53 (1·48-1·57) at 1-5 years, to 1·15 (1·11-1·20) at 5-10 years, and 1·04 (1·00-1·07) at 10 years and later. The risk was increased for both sexes and all age groups. INTERPRETATION: Autoimmune disorders are associated with a high risk of pulmonary embolism in the first year after hospital admission. Our findings suggest that these disorders in general should be regarded as hypercoagulable disorders. FUNDING: Swedish Research Council, Swedish Council for Working Life and Social Research, Swedish Research Council Formas, Region Skåne.},
  author       = {Zöller, Bengt and Li, Xinjun and Sundquist, Jan and Sundquist, Kristina},
  issn         = {1474-547X},
  language     = {eng},
  pages        = {244--249},
  publisher    = {Elsevier Limited},
  series       = {The Lancet},
  title        = {Risk of pulmonary embolism in patients with autoimmune disorders: a nationwide follow-up study from Sweden.},
  url          = {http://dx.doi.org/10.1016/S0140-6736(11)61306-8},
  volume       = {379},
  year         = {2012},
}