Stroke Literature Synopses: Clinical Science
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Kamel H, Navi BB, Sriram N, Hovsepian DA, Devereux RB, Elkind MS. Risk of thrombotic event after the 6-week postpartum period [published online ahead of print February 13, 2014]. N Engl J Med. doi: 10.1056/NEJMoa1311485. http://www.nejm.org/doi/full/10.1056/NEJMoa1311485. Accessed March 19, 2014.
It has long been established that women have an increased risk of postpartum thrombotic events ≤6 weeks after delivery; however, little is known about thrombotic risk beyond that period. Using administrative claims data on all discharges from nonfederal emergency departments and acute care hospitals in California from 2005 to 2010, Kamel et al retrospectively assessed risk of thrombotic events (composite primary outcome of ischemic stroke, myocardial infarction, or venous thromboembolism) among individuals aged ≥12 years hospitalized for labor and delivery. Using a crossover cohort design, they assessed each individual’s likelihood of a thrombotic event during sequential 6-week periods after delivery with likelihood of an event during the corresponding 6-week period 1 year later.
Among 1 687 930 individuals, 1015 had thrombotic events (248 strokes, 47 myocardial infarctions, and 720 venous thromboemboli) during 1-year plus ≤24-week follow-up after delivery. Compared with individuals without postpartum thrombosis, those with thrombotic events …