Causes of death after first time community-acquired venous thromboembolism (VTE) diagnosed in unselected patients at the emergency department (ED) was investigated. The study consists of all patients > 18 years of age who had a visit for any medical reason to any of 5 different ED in Stockholm County, Sweden from 1st January 2016 to 31st December 2017. We have identified all patients with a first registered incident VTE; deep vein thrombosis (DVT) and/or pulmonary embolism (PE) during the study period. Cox regression models were used to estimate hazards ratios (HR) with 95% confidence intervals (CIs) for all-cause mortality and cause-specific death in patients with DVT or PE using all other patients as the reference group. In total, 359,884 patients had an ED visit during the study period of whom about 2.1% were diagnosed with VTE (DVT = 4,384, PE = 3,212). The patients with VTE were older compared to the control group. During a mean follow up of 2.1 years, 1567 (21%) and 23,741(6.7%) patients died within the VTE and reference group, respectively. The adjusted risk of all-cause mortality was nearly double in patients with DVT (HR 1.7; 95% CI, 1.5–1.8) and more than 3-fold in patients with PE (HR 3.4; 95% CI, 3.1–3.6). While the risk of cancer related death was nearly 3-fold in patient with DVT (HR 2.7; 95% CI, 2.4–3.1), and 5-fold in PE (HR 5.4; 95% CI, 4.9-6.0 respectively). The diagnosis of PE during the ED visit was associated with a significantly higher risk of cardiovascular death (HR 2.2; 95% CI, 1.9–2.6). Patients with VTE have an elevated risk of all-cause mortality, including cardiovascular death.

中文翻译：

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首次静脉血栓栓塞后的死亡原因

对急诊科 (ED) 未经选择的患者首次诊断出社区获得性静脉血栓栓塞 (VTE) 后的死亡原因进行了调查。该研究包括 2016 年 1 月 1 日至 2017 年 12 月 31 日期间因任何医疗原因到瑞典斯德哥尔摩县 5 个不同急诊室就诊的所有年龄 > 18 岁的患者。我们已确定所有首次登记发生 VTE 的患者; 研究期间发生深静脉血栓（DVT）和/或肺栓塞（PE）。使用 Cox 回归模型以所有其他患者作为参考组，以 95% 置信区间 (CI) 估计 DVT 或 PE 患者全因死亡率和特定原因死亡的风险比 (HR)。研究期间总共有 359,884 名患者到急诊室就诊，其中约 2.1% 被诊断为 VTE（DVT = 4,384，PE = 3,212）。与对照组相比，VTE 患者年龄较大。在平均 2.1 年的随访期间，VTE 组和参考组中分别有 1567 名 (21%) 和 23,741 名 (6.7%) 患者死亡。DVT 患者的调整后全因死亡率风险几乎翻倍（HR 1.7；95% CI，1.5-1.8），而 PE 患者的调整后全因死亡率风险则高出 3 倍以上（HR 3.4；95% CI，3.1-3.6）。而 DVT 患者的癌症相关死亡风险几乎是其 3 倍（HR 2.7；95% CI，2.4-3.1），PE 患者的癌症相关死亡风险是 PE 患者的 5 倍（HR 5.4；95% CI，4.9-6.0）。急诊室就诊期间诊断出 PE 与心血管死亡风险显着升高相关（HR 2.2；95% CI，1.9-2.6）。VTE 患者的全因死亡风险较高，包括心血管死亡。