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      Combined oral contraceptives: venous thrombosis

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          Abstract

          Combined oral contraceptive (COC) use has been associated with venous thrombosis (VT) (i.e., deep venous thrombosis and pulmonary embolism). The VT risk has been evaluated for many estrogen doses and progestagen types contained in COC but no comprehensive comparison involving commonly used COC is available.

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          Bias in meta-analysis detected by a simple, graphical test

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            Incidence and mortality of venous thrombosis: a population-based study.

            Estimates of the incidence of venous thrombosis (VT) vary, and data on mortality are limited. We estimated the incidence and mortality of a first VT event in a general population. From the residents of Nord-Trøndelag county in Norway aged 20 years and older (n = 94 194), we identified all cases with an objectively verified diagnosis of VT that occurred between 1995 and 2001. Patients and diagnosis characteristics were retrieved from medical records. Seven hundred and forty patients were identified with a first diagnosis of VT during 516,405 person-years of follow-up. The incidence rate for all first VT events was 1.43 per 1000 person-years [95% confidence interval (CI): 1.33-1.54], that for deep-vein thrombosis (DVT) was 0.93 per 1000 person-years (95% CI: 0.85-1.02), and that for pulmonary embolism (PE) was 0.50 per 1000 person-years (95% CI: 0.44-0.56). The incidence rates increased exponentially with age, and were slightly higher in women than in men. The 30-day case-fatality rate was higher in patients with PE than in those with DVT [9.7% vs. 4.6%, risk ratio 2.1 (95% CI: 1.2-3.7)]; it was also higher in patients with cancer than in patients without cancer [19.1% vs. 3.6%, risk ratio 3.8 (95% CI 1.6-9.2)]. The risk of dying was highest in the first months subsequent to the VT, after which it gradually approached the mortality rate in the general population. This study provides estimates of incidence and mortality of a first VT event in the general population.
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              Evaluating non-randomised intervention studies

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                Author and article information

                Journal
                Cochrane Database of Systematic Reviews
                Wiley
                14651858
                March 03 2014
                Affiliations
                [1 ]Instituto Previdencia dos Servidores do Estado de Minas Gerais; Minas Gerais Brazil
                [2 ]University College London; Department of Epidemiology and Public Health; London UK
                [3 ]Leiden University Medical Center; Epidemiology; PO Box 9600 Leiden Netherlands 2300RC
                [4 ]Leiden University Medical Center; Department of Clinical Epidemiology; PO Box 9600 Leiden Netherlands 2300RC
                [5 ]Leiden University Medical Center; Department of Gynaecology, Division of Reproductive Medicine and Dept. of Clinical Epidemiology; PO Box 9600 Albinusdreef 2 Leiden Netherlands NL 2300 RC
                [6 ]Leiden University Medical Center; Department of Medical Statistics; PO Box 9600 Leiden Netherlands 2300 RC
                Article
                10.1002/14651858.CD010813.pub2
                24590565
                171f537d-52fa-4638-82a3-91bea5c1636f
                © 2014
                History

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