A Large, Population Based Study of Sex Differences In the Risk of Recurrent Venous Thromboembolism
Bibliographic record
Abstract
Abstract Abstract 4204 Background. Most reports of patient sex differences in the risk of recurrent VTE have been based on small or moderate sized cohorts of selected patients with VTE. Objectives. We used the administrative hospital discharge registry of Quebec, Canada to conduct a population-based retrospective cohort study to evaluate the effect of sex on rates of recurrent VTE. Methods. Using data from the province-wide hospital discharge database (Med-Echo) which systematically records information on all hospital admissions in the province of Quebec since 1967, we constructed a cohort of all individuals who had a first-time discharge diagnosis of deep vein thrombosis (DVT) or pulmonary embolism (PE) between January 1, 1996 and December 31, 2004 and no prior discharge diagnosis for DVT or PE back to 1983. Subjects were followed from the time of diagnosis until first VTE recurrence, death, or end of study (December 31, 2005). DVT and PE were defined based on the International Classification of Diseases, 9th edition, Clinical Modification. Results. The cohort comprised 55,314 patients (43% men and 57% women) with incident VTE. Mean age was 61.9 years (60.4 years (men) vs. 63.1 years (women); p=0.0001), and 33,535 (61%) had DVT alone, 14,574 (26%) had PE alone and 7,205 (13%) had both DVT and PE. During a mean follow-up of 3.9 years, 5,243 (9.5%) of patients developed recurrent VTE, which corresponded to an incidence rate of 2.4 events per 100 patient-years (95% confidence interval (CI), 2.3–2.5 per 100 patient-years). In survival analysis, men had significantly higher rate of recurrence than women (age- and comorbidity-adjusted hazard ratio = 1.14; 95% CI, 1.08–1.21), and at 5 years, the cumulative risk of recurrent VTE was 8.3% among men vs. 7.3% among women (p=0.0001). Mean age at the time of VTE recurrence in men vs. women was 61.1 years and 64.4 years, respectively (p=0.0001). Conclusion. Our study of over 55,000 patients hospitalized with VTE is the largest to date to report an effect of patient sex on risk of VTE recurrence, with men having about a 15% higher risk of recurrence than women. This provides further evidence that the difference in risk of VTE recurrence between men and women is significant and if confirmed by ongoing prospective management studies, patient sex should be considered in determining duration of anticoagulation treatment in patients with VTE. Disclosures: Taglalakis: Pfizer: Research Funding; Sanofi Aventis: Honoraria. Kahn:Sigvaris: Research Funding; sanofi-aventis: Advisory Board, Research Funding; Boehringer Ingelheim:.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".