Deep vein thrombosis and major adverse limb events in diabetic patients: a population-based cohort study

Abstract

Background Little is known about the association between deep vein thrombosis (DVT) and arterial complications in patients with type 2 diabetes. The aim of this retrospective cohort study was to assess the influence of prior DVT on major adverse limb events (MALEs) and major adverse cardiovascular events (MACEs) in patients with type 2 diabetes. Methods Patients with type 2 diabetes with or without a history of DVT hospitalization from 2001 to 2013 were identified in the National Health Insurance Research Database of Taiwan and included in this study. Propensity score matching was used to balance the baseline characteristics between groups. Cox proportional and Fine and Gray subdistribution hazard models were used to examine association a between history of DVT and the risks of MALEs and MACEs. Results During a mean follow-up of 5.2 years (standard deviation: 3.9 years), the DVT group (n = 2017) had a higher risk of MALE composite outcome (8.4% vs. 5.2%; subdistribution hazard ratio [SHR] 1.60, 95% CI 1.34–1.90). Among the individual components, the DVT group had higher risks of foot ulcer (5.2% vs. 2.6%, SHR 1.96, 95% CI 1.57–2.45), gangrene (3.4% vs. 2.3%, SHR 1.44, 95% CI 1.10–1.90) and amputation (2.5% vs. 1.7%; SHR 1.42, 95% CI 1.03–1.95). Conclusions The presence of DVT may be associated with an increased risk of MALEs, major amputation, and thromboembolism, contributing to a higher risk of mortality in patients with type 2 diabetes.