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Prominent seasonal variation in pulmonary embolism than deep vein thrombosis incidence: a Korean venous thrombosis epidemiology study

Korean Journal of Internal Medicine 2020년 35권 3호 p.682 ~ 691
홍준식 ( Hong Jun-Shik ) - Seoul National University Hospital Department of Internal Medicine

이주현 ( Lee Ju-Hyun ) - Seoul National University Bundang Hospital Department of Internal Medicine
이지연 ( Lee Ji-Yun ) - Seoul National University Bundang Hospital Department of Internal Medicine
이정옥 ( Lee Jeong-Ok ) - Seoul National University Bundang Hospital Department of Internal Medicine
최원일 ( Choi Won-Il ) - Keimyung University Dongsan Medical Center Department of Internal Medicine
안소연 ( Ahn So-Yeon ) - Seoul National University Bundang Hospital Medical Research Collaborating Center
임연희 ( Lim Youn-Hee ) - Seoul National University Medical Research Center Institute of Environmental Medicine
방수미 ( Bang Soo-Mee ) - Seoul National University Bundang Hospital Department of Internal Medicine
오도연 ( Oh Do-Yeun ) - CHA University CHA Bundang Medical Center Department of Internal Medicine

Abstract


Background/Aims: Seasonal variation is an environmental factor proposed to affect the incidence of venous thromboembolism (VTE). However, VTE seasonal variation is not well studied in Asian populations, which have different genetic determinants of VTE compared to Westerners. The present study aimed at investigating seasonal variation of VTE occurrence and the effect of various demographic factors (i.e., age, sex, and co-morbidities) on variation.

Methods: VTE seasonal variation was evaluated in 59,626 index cases (from January 2009 to December 2013) in the Korean Health Insurance Review and Assessment Service database. We quantified and compared VTE occurrence across four seasons, and additionally assessed monthly through a chronobiological analysis.

Results: VTE incidence varied both seasonally and monthly, with new cases peaking in the winter (January and February) and the lowest incidence in the summer (August and September). After adjusting for sex, age, type of VTE, and combined cancer diagnosis, winter remained a significant independent factor driving VTE incidence. Additionally, seasonal variation was prominent in patients aged 60 years or older and in patients with pulmonary embolism, but not so prominent in patients of aged less than 60 years and patients with deep vein thrombosis.

Conclusions: Seasonal variation was a weak but independent contributor to VTE incidence in a Korean population diagnosed from 2009 to 2013, especially in those individuals with old age or suffering from a pulmonary embolism.

키워드

Venous thromboembolism; Pulmonary embolism; Deep vein thrombosis; Epidemiology; Seasons
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