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A hypothesis - generating Swedish extended national cross-sectional family study of multimorbidity severity and venous thromboembolism

Ahrén, Jonatan LU orcid ; Pirouzifard, MirNabi LU ; Holmquist, Björn LU orcid ; Sundquist, Jan LU ; Halling, Anders LU ; Sundquist, Kristina LU and Zöller, Bengt LU orcid (2023) In BMJ Open 13(6). p.1-8
Abstract

OBJECTIVES: Venous thromboembolism (VTE) is a common worldwide disease. The burden of multimorbidity, that is, two or more chronic diseases, has increased. Whether multimorbidity is associated with VTE risk remains to be studied. Our aim was to determine any association between multimorbidity and VTE and any possible shared familial susceptibility.

DESIGN: A nationwide extended cross-sectional hypothesis - generating family study between 1997 and 2015.

SETTING: The Swedish Multigeneration Register, the National Patient Register, the Total Population Register and the Swedish cause of death register were linked.

PARTICIPANTS: 2 694 442 unique individuals were analysed for VTE and multimorbidity.

MAIN OUTCOMES AND... (More)

OBJECTIVES: Venous thromboembolism (VTE) is a common worldwide disease. The burden of multimorbidity, that is, two or more chronic diseases, has increased. Whether multimorbidity is associated with VTE risk remains to be studied. Our aim was to determine any association between multimorbidity and VTE and any possible shared familial susceptibility.

DESIGN: A nationwide extended cross-sectional hypothesis - generating family study between 1997 and 2015.

SETTING: The Swedish Multigeneration Register, the National Patient Register, the Total Population Register and the Swedish cause of death register were linked.

PARTICIPANTS: 2 694 442 unique individuals were analysed for VTE and multimorbidity.

MAIN OUTCOMES AND MEASURES: Multimorbidity was determined by a counting method using 45 non-communicable diseases. Multimorbidity was defined by the occurrence of ≥2 diseases. A multimorbidity score was constructed defined by 0, 1, 2, 3, 4 or 5 or more diseases.

RESULTS: Sixteen percent (n=440 742) of the study population was multimorbid. Of the multimorbid patients, 58% were females. There was an association between multimorbidity and VTE. The adjusted odds ratio (OR) for VTE in individuals with multimorbidity (2 ≥ diagnoses) was 3.16 (95% CI: 3.06 to 3.27) compared with individuals without multimorbidity. There was an association between number of diseases and VTE. The adjusted OR was 1.94 (95% CI: 1.86 to 2.02) for one disease, 2.93 (95% CI: 2.80 to 3.08) for two diseases, 4.07 (95% CI: 3.85 to 4.31) for three diseases, 5.46 (95% CI: 5.10 to 5.85) for four diseases and 9.08 (95% CI: 8.56 to 9.64) for 5 ≥ diseases. The association between multimorbidity and VTE was stronger in males OR 3.45 (3.29 to 3.62) than in females OR 2.91 (2.77 to 3.04). There were significant but mostly weak familial associations between multimorbidity in relatives and VTE.

CONCLUSIONS: Increasing multimorbidity exhibits a strong and increasing association with VTE. Familial associations suggest a weak shared familial susceptibility. The association between multimorbidity and VTE suggests that future cohort studies where multimorbidity is used to predict VTE might be worthwhile.

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author
; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Male, Female, Humans, Venous Thromboembolism/etiology, Sweden/epidemiology, Multimorbidity, Cross-Sectional Studies, Risk Factors
in
BMJ Open
volume
13
issue
6
article number
e072934
pages
1 - 8
publisher
BMJ Publishing Group
external identifiers
  • scopus:85163903325
  • pmid:37328186
ISSN
2044-6055
DOI
10.1136/bmjopen-2023-072934
language
English
LU publication?
yes
additional info
© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY. Published by BMJ.
id
462633b8-9d06-45cf-8281-2d36cd64b0b5
date added to LUP
2023-09-14 10:00:29
date last changed
2024-04-20 03:13:55
@article{462633b8-9d06-45cf-8281-2d36cd64b0b5,
  abstract     = {{<p>OBJECTIVES: Venous thromboembolism (VTE) is a common worldwide disease. The burden of multimorbidity, that is, two or more chronic diseases, has increased. Whether multimorbidity is associated with VTE risk remains to be studied. Our aim was to determine any association between multimorbidity and VTE and any possible shared familial susceptibility.</p><p>DESIGN: A nationwide extended cross-sectional hypothesis - generating family study between 1997 and 2015.</p><p>SETTING: The Swedish Multigeneration Register, the National Patient Register, the Total Population Register and the Swedish cause of death register were linked.</p><p>PARTICIPANTS: 2 694 442 unique individuals were analysed for VTE and multimorbidity.</p><p>MAIN OUTCOMES AND MEASURES: Multimorbidity was determined by a counting method using 45 non-communicable diseases. Multimorbidity was defined by the occurrence of ≥2 diseases. A multimorbidity score was constructed defined by 0, 1, 2, 3, 4 or 5 or more diseases.</p><p>RESULTS: Sixteen percent (n=440 742) of the study population was multimorbid. Of the multimorbid patients, 58% were females. There was an association between multimorbidity and VTE. The adjusted odds ratio (OR) for VTE in individuals with multimorbidity (2 ≥ diagnoses) was 3.16 (95% CI: 3.06 to 3.27) compared with individuals without multimorbidity. There was an association between number of diseases and VTE. The adjusted OR was 1.94 (95% CI: 1.86 to 2.02) for one disease, 2.93 (95% CI: 2.80 to 3.08) for two diseases, 4.07 (95% CI: 3.85 to 4.31) for three diseases, 5.46 (95% CI: 5.10 to 5.85) for four diseases and 9.08 (95% CI: 8.56 to 9.64) for 5 ≥ diseases. The association between multimorbidity and VTE was stronger in males OR 3.45 (3.29 to 3.62) than in females OR 2.91 (2.77 to 3.04). There were significant but mostly weak familial associations between multimorbidity in relatives and VTE.</p><p>CONCLUSIONS: Increasing multimorbidity exhibits a strong and increasing association with VTE. Familial associations suggest a weak shared familial susceptibility. The association between multimorbidity and VTE suggests that future cohort studies where multimorbidity is used to predict VTE might be worthwhile.</p>}},
  author       = {{Ahrén, Jonatan and Pirouzifard, MirNabi and Holmquist, Björn and Sundquist, Jan and Halling, Anders and Sundquist, Kristina and Zöller, Bengt}},
  issn         = {{2044-6055}},
  keywords     = {{Male; Female; Humans; Venous Thromboembolism/etiology; Sweden/epidemiology; Multimorbidity; Cross-Sectional Studies; Risk Factors}},
  language     = {{eng}},
  month        = {{06}},
  number       = {{6}},
  pages        = {{1--8}},
  publisher    = {{BMJ Publishing Group}},
  series       = {{BMJ Open}},
  title        = {{A hypothesis - generating Swedish extended national cross-sectional family study of multimorbidity severity and venous thromboembolism}},
  url          = {{http://dx.doi.org/10.1136/bmjopen-2023-072934}},
  doi          = {{10.1136/bmjopen-2023-072934}},
  volume       = {{13}},
  year         = {{2023}},
}