Smoking, Surgery, and Venous Thromboembolism Risk in Women: UK Cohort Study
Background—Evidence about the effect of smoking on venous thromboembolism risk, generally and in the post-operative period, is limited and inconsistent. We examined the incidence of venous thromboembolism in relation to smoking habits, both in the absence of surgery and in the first 12 post-operative weeks in a large prospective study of UK women.
Methods and Results—During 6 years' follow-up of 1,162,718 women, mean age 56 years, 4630 were admitted to hospital for or died from venous thromboembolism. In the absence of surgery, current smokers had a significantly increased incidence of venous thromboembolism compared to never smokers (adjusted relative risk [RR]=1.38 [95% confidence interval 1.28-1.48]), with significantly greater risks in heavier than lighter smokers (RRs 1.47 [1.34-1.62] and 1.29 [1.17-1.42] for 15+ versus <15 cigarettes/day). Current smokers were also more likely to have surgery than never smokers (1.12 [1.12-1.13]). Among women who had surgery, the incidence of venous thromboembolism in the first 12 post-operative weeks was significantly greater in current than never smokers (1.16 [1.02-1.30]).
Conclusions—Venous thromboembolism incidence was increased in current smokers, both in the absence of surgery and in the 12 weeks following surgery. Smoking is another factor to consider when assessing venous thromboembolism risk in patients undergoing surgery.
- Received January 17, 2013.
- Accepted February 15, 2013.