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. 2012 Jan;39(1):125-32.
doi: 10.1183/09031936.00041411. Epub 2011 Jul 7.

Pulmonary fibrosis is associated with an elevated risk of thromboembolic disease

D B Sprunger  1 , A L Olson, T J Huie, E R Fernandez-Perez, A Fischer, J J Solomon, K K Brown, J J Swigris
Affiliations

Pulmonary fibrosis is associated with an elevated risk of thromboembolic disease

D B Sprunger et al. Eur Respir J. 2012 Jan.

Abstract

Recent epidemiological studies have suggested an increased risk of venous thromboembolism (VTE) in lung fibrosis. Large-scale epidemiological data regarding the risk of VTE in pulmonary fibrosis-associated mortality have not been published. Using data from the National Center for Health Statistics from 1988-2007, we determined the risk of VTE in decedents with pulmonary fibrosis in the USA. We analysed 46,450,489 records, of which 218,991 met our criteria for idiopathic pulmonary fibrosis. Among these, 3,815 (1.74%) records also contained a diagnostic code for VTE. The risk of VTE in pulmonary fibrosis decedents was 34% higher than in the background population, and 44% and 54% greater than among decedents with chronic obstructive pulmonary disease and lung cancer, respectively. Those with VTE and pulmonary fibrosis died at a younger age than those with pulmonary fibrosis alone (females: 74.3 versus 77.4 yrs (p<0.0001); males: 72.0 versus 74.4 yrs (p<0.0001)). Decedents with pulmonary fibrosis had a significantly greater risk of VTE. Those with VTE and pulmonary fibrosis died at a younger age than those with pulmonary fibrosis alone. These data suggest a link between a pro-fibrotic and a pro-coagulant state.

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Figures

FIGURE 1
FIGURE 1
The overall risk of venous thromboembolic disease in idiopathic pulmonary fibrosis when compared with the background population, for females by age. The odds ratio (OR) was only significant for those in the older age groups (65–74, 75–84 and ≥85 yrs; p<0.05), while the risk was not significantly elevated in the younger age groups (25–34, 35–44, 45–54 and 55–64 yrs; p=0.4830, p=0.7966, p=0.6809 and p=0.4339, respectively). Data are presented as OR with 95% CI.
FIGURE 2
FIGURE 2
The overall risk of venous thromboembolic disease in idiopathic pulmonary fibrosis when compared with the background population, for males by age. All age groups were statistically significant (p<0.05). Data are presented as odds ratio (OR) with 95% CI.
FIGURE 3
FIGURE 3
The annual risk of venous thromboembolic disease in idiopathic pulmonary fibrosis when compared with chronic obstructive pulmonary disease. The odds ratio (OR) was statistically significant for all years analysed (p<0.05). Data are presented as OR with 95% CI.
FIGURE 4
FIGURE 4
The annual risk of venous thromboembolic disease in idiopathic pulmonary fibrosis when compared with lung cancer. The odds ratio (OR) was statistically significant (p<0.05) for all years except 2004 (p=0.53) and 2005 (p=0.65). Data are presented as OR with 95% CI.
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