P-piller, kirurgi och gipsning ger hög risk för venös trombos hos kvinnor. Bättre profylax behövs vid kirurgiska ingrepp, visar fall-kontrollstudie
Sammanfattning
We conducted a case control study including 2?835 women 18 to 64 years of age to assess the importance of acquired and genetic risk factors for a first time venous thromboembolism. We also described use of low molecular heparin as prophylaxis in connection with surgery and plaster casts. Combined hormonal contraception, surgery and plaster casts conveyed the highest risks (odds ratios: 8–52). Menopausal hormone therapy, obesity, carrying the prothrombin gene mutation or carrying the factor V Leiden mutation were all associated with moderate increased risks (odds ratios: 2–4). Smoking and overweight had the lowest risks (odds ratios below 2). Of the cases 50 % with a recent surgery and 36 % with a plaster cast had received low molecular heparin as prophylaxis for an average of nine days. Our findings point at the need to revise the guidelines for prophylaxis in connection with surgery and plaster cast, and that hormonal contraception with progesterone only is a safe alternative to combined hormonal contraception.