Epilepsy increases risk of venous thromboembolism

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People with epilepsy have risk factors associated with venous thromboembolism (VTE) independent of chronic neurologic illnesses, according to a study published in Epilepsia.

Gabriel U. Martz, MD, of the Medical University of South Carolina and colleagues investigated patients with epilepsy and patients with migraines, finding that those with epilepsy had an elevated risk of VTE. Previously, the risk of VTE in patients with epilepsy had not been studied.

All inpatient, ED, and hospital-based outpatient encounters in South Carolina from Jan. 1, 2000 through Dec. 31, 2011 were included in the study. The primary outcome variable of VTE was defined as having a diagnosis of VTE at or after the diagnosis of epilepsy or migraine.

Overall, 97,900 people with epilepsy and 138,497 people with migraines, a comparable neurologic condition, were evaluated. VTE occurred in 2.7% of the patients with epilepsy and in 0.6% of the patients with migraine.

VTE also had a strong association with higher numbers of comorbidities. Comorbidities occurred in 52% of patients with epilepsy compared with 23% of people with migraines. However, the impact of comorbidities on VTE risk was larger in patients with migraines.

Taking all factors into account, VTE occurrence in people with epilepsy is similar to that of people with cancer, the researchers concluded.

A loose blood clot in a venous thromboembolism.
A loose blood clot in a venous thromboembolism.
This statewide study assessed the risk of venous thromboembolism (VTE) in people with epilepsy (PWEs). Higher VTE risk in PWE than PWM suggests risk factors associated with epilepsy, independent of chronic neurologic illness. VTE occurrence in PWE is comparable to published rates among people with cancer.

Results

  • A total of 138,497 people with migraine (PWMs) and 67,900 PWEs (32,186 DE, 35,714 PE) were included.
  • VTE occurred in 2.7% of PWEs (4.2% among DE), and 0.6% of PWMs.
  • The hazard ratio for VTE in DE compared with PWMs was 3.08 (95% CI 2.76-3.42), adjusted for all covariables.
  • Higher numbers of comorbidities were strongly associated with VTE.
  • PWE had higher numbers of comorbidities (52% with 2+ comorbidities versus 23% of PWM), but the impact of comorbidities on VTE risk was larger in PWM.

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