title: Active tuberculosis and venous thromboembolism: association according to international classification of diseases, ninth revision hospital discharge diagnosis codes.
abstract: BACKGROUND
  Infections are risk factors for venous thromboembolism (VTE), especially if severe and acute. The role of chronic infections such as active tuberculosis is ill defined, although several case reports and small series have suggested an association between tuberculosis and VTE.
  
  
  METHODS
  Using data from the Premier Perspective database (27 659 947 admissions), we performed a multivariate analysis to assess the specific VTE risk associated with tuberculosis. The analysis was adjusted on classic risk factors for VTE.
  
  
  RESULTS
  The prevalence of VTE among patients with active tuberculosis was 2.07% (95% confidence interval [CI], 1.62%-2.59%). In a multivariate analysis model, adults with active tuberculosis had a greater risk of VTE than those without (odds ratio, 1.55 [95% CI, 1.23-1.97], P < .001), close to the previously reported risk associated with neoplasia. No particular link was found between pulmonary tuberculosis and pulmonary embolism, or between extrapulmonary tuberculosis and deep vein thrombosis. This may suggest the preponderant role of a systemic hypercoagulable state over an intrathoracic venous compression mechanism. In-hospital mortality of patients with both active tuberculosis and VTE (11/72 [15%]) was higher than mortality of patients with only active tuberculosis (92/3413 [2.7%]) or only VTE (5062/199 480 [2.5%]) (P < .001). Pulmonary embolism was more frequent in black patients, suggesting that this population, which is also more likely to suffer from tuberculosis, should be followed carefully.
  
  
  CONCLUSIONS
  Tuberculosis must be considered as a pertinent risk factor for VTE and should be included in thromboembolism risk evaluation similar to any acute and severe infection.
authors.affiliation: Université Grenoble-Alpes, CNRS-TIMC-IMAG UMR5525.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Dentan
authors.forename: Olivier
authors.initials: O
authors.lastname: Epaulard
authors.forename: Damien
authors.initials: D
authors.lastname: Seynaeve
authors.forename: Céline
authors.initials: C
authors.lastname: Genty
authors.forename: Jean-Luc
authors.initials: JL
authors.lastname: Bosson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D038801:International Classification of Diseases / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018570:Risk Assessment; D014376:Tuberculosis / Q000150:complications*; D054556:Venous Thromboembolism / Q000453:epidemiology* / Q000209:etiology*; D055815:Young Adult
keywords: Premier Perspective database; deep vein thrombosis; pulmonary embolism; tuberculosis; venous thromboembolism