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Title: Smoking, surgery, and venous thromboembolism risk in women: United Kingdom cohort study.
Authors: Sweetland S; Parkin L; Balkwill A; Green J; Reeves G; Beral V; for the Million Women Study Collaborators (incl. Canfell K)
Year: 2013
Journal Title: Circulation
Volume: 137
Page number start: 1276
Page number end: 1282
Abstract: Background—Evidence about the effect of smoking on venous thromboembolism risk, generally and in the postoperative period, is limited and inconsistent. We examined the incidence of venous thromboembolism in relation to smoking habits, both in the absence of surgery and in the first 12 postoperative weeks, in a large prospective study of women in the United Kingdom. Methods and Results—During 6 years’ follow-up of 1 162718 women (mean age 56 years), 4630 were admitted to hospital for or died of venous thromboembolism. In the absence of surgery, current smokers had a significantly increased incidence of venous thromboembolism compared with never-smokers (adjusted relative risk 1.38, 95% confidence interval 1.28– 1.48), with significantly greater risks in heavier than lighter smokers (relative risks 1.47 [95% confidence interval 1.34– 1.62] and 1.29 [95% confidence interval 1.17–1.42] for ≥15 versus <15 cigarettes per day). Current smokers were also more likely to have surgery than never-smokers (relative risk 1.12, 95% confidence interval 1.12–1.13). Among women who had surgery, the incidence of venous thromboembolism in the first 12 postoperative weeks was significantly greater in current than never-smokers (relative risk 1.16, 95% confidence interval 1.02–1.30). Conclusions—Venous thromboembolism incidence was increased in current smokers, both in the absence of surgery and in the 12 weeks after surgery. Smoking is another factor to consider in the assessment of venous thromboembolism risk in patients undergoing surgery.
Division: Cancer Research Division
Funding Body: This study was funded by Cancer Research UK, the NHS Breast Cancer Screening Program, the UK Medical Research Council, and the Health and Safety Executive. KC was supported by a NHMRC Fellowship (GNT1007994)
DOI: 10.1161/CIRCULATIONAHA.113.001428
Appears in Collections:Research Articles

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