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. 2018 May 27;2(3):469-480.
doi: 10.1002/rth2.12113. eCollection 2018 Jul.

Immigration, region of origin, and the epidemiology of venous thromboembolism: A population-based study

Alejandro Lazo-Langner  1   2   3 , Kuan Liu  3 , Salimah Shariff  3 , Amit X Garg  2   3   4 , Joel G Ray  5   6
Affiliations

Immigration, region of origin, and the epidemiology of venous thromboembolism: A population-based study

Alejandro Lazo-Langner et al. Res Pract Thromb Haemost. .

Abstract

Background: Venous thromboembolism (VTE) epidemiology has been mainly studied in populations largely of European ancestry.

Objectives: To assess the epidemiology of VTE in immigrants to Ontario, Canada.

Patients/methods: We conducted a population-based retrospective cohort study using linked health-care and administrative databases. We included 1 195 791 immigrants to Ontario and 1 195 791 nonimmigrants, matched on age, sex, and place of residence. The main exposure was ethnicity according to world region of origin, using a previously validated algorithm. The main outcome was incident onset of VTE during the period of observation. Risk ratios (RR) were calculated using Poisson regression models.

Results: The incidence rate (IR) of VTE was lower among immigrants (0.87 per 1000 PY; 95% confidence interval [CI] 0.85-0.89) than nonimmigrants (1.59 per 1000 PY; 95% CI 1.56-1.61). Age- and sex-standardized IR were lower among East and South Asian immigrants. Compared to immigrants for predominantly White regions, age- and sex-specific RRs were consistently lower for East Asian (0.18-0.30) and South Asian (0.29-0.75) immigrants. In contrast, the RRs of VTE among Black (0.38-1.50), Latin American (0.29-1.25), Arab/Middle Eastern (0.44-1.08) and West Asian (0.31-1.16) immigrants were not significantly different from White immigrants.

Conclusions: In Ontario, the incidence of VTE is lower among immigrants compared to nonimmigrants. East and South Asian immigrants have a lower risk of VTE compared to White immigrants.

Keywords: cohort; epidemiology; ethnicity; observational; venous thromboembolism.

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Figures

Figure 1
Figure 1
Geographic distribution of ethnicities as defined in the study
Figure 2
Figure 2
Age‐standardized Incidence rates and 95% confidence intervals of venous thromboembolism for male and female immigrants divided by immigrant group
Figure 3
Figure 3
Venous thromboembolism risk ratios and 95% confidence intervals for male immigrants to Ontario divided by geographically defined ethnic group, compared to White immigrants within the same age group
Figure 4
Figure 4
Venous thromboembolism risk ratios and 95% confidence intervals for female immigrants to Ontario divided by geographically defined ethnic group, compared to White immigrants within the same age group
See this image and copyright information in PMC

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