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© 1992 Oxford University Press

research-article

Risk Factors for Fatal Venous Thromboembolism in Young Women: A Case-Control Study

MARGARET THOROGOOD*, JIM MANN{dagger}, MICHAEL MURPHY* and MARTIN VESSEY*

*Department of Public Health md Primary Care, University of Oxford Gibson Building, Radcliffe Infirmary, Oxford OX2 6HE, UK
{dagger}Department of Human Nutrition, University of Otago PO Box 56, Dunedin, New Zealand

Thorogood M (Department of Public Health and Primary Care, University of Oxford, Gibson Building, Radcliffe Infirmary, Oxford, UK), Mann J, Murphy M and Vessey M. Risk factors for fatal venous thromboembolism in young women: A case-control study. International Journal of Epidemiology 1992; 21: 48–52.

A case-control study of fatal venous thromboembolism in young women is described. Sixty women aged between 16 and 39 who died from thromboembolism in England and Wales between 1986 and 1988 were included in the study. Two living controls matched for age and marital status were sought from the records of the general practitioner with whom each case was registered. Some 115 controls were included in the study. The cases had a significantly higher prevalence of a history of major illness, particularly thrombotic episodes, than the controls. The odds ratio (OR) of a fatal thromboembolisrn in women who had a history of venous thrombosis was 4.0 (95% CI: 1.4–11.5). There was also a significantly higher frequency of a recent operation or accident amongst the cases than the controls (OR = 11.1, 95% CI: 1.3–92.5). There was no significant excess of oral contraceptive use amongst the cases. The overall OR associated with current use of oral contraceptives was 1.6(95% CI: 0.7–3.4), while the corresponding OR for ‘idiopathic’ disease was 2.1(95% CI: 0.8–5.2). These risks are considerably smaller than those observed in previous studies. The observed risk may be low because the dosage of oestrogen in modern oral contraceptive preparations has been reduced, but it may also be because the cases of fatal venous thromboembolisen included in this study represent only a small propor tion of all cases of venous thromboembolism; a disease which is rarely fatal in young women. These results cannot necessarily be extrapolated to nonfatal venous thromboembolism.

Received 1 July 1991


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