Influenza infection and risk of acute pulmonary embolism
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BioMed Central
Open Access
Original clinical investigation
Influenza infection and risk of acute pulmonary embolism Matthijs van Wissen*1,2, Tymen T Keller1, Brechje Ronkes1, Victor EA Gerdes1,2, Hans L Zaaijer3, Eric CM van Gorp2, Dees PM Brandjes2, Marcel Levi1 and Harry R Büller1 Address: 1Department of Vascular Medicine, Academic Medical Center, Amsterdam, The Netherlands, 2Department of Internal Medicine, Slotervaart Hospital, Amsterdam, The Netherlands and 3Department of Microbiology, Academic Medical Center, Amsterdam, The Netherlands Email: Matthijs van Wissen* - [email protected]; Tymen T Keller - [email protected]; Brechje Ronkes - [email protected]; Victor EA Gerdes - [email protected]; Hans L Zaaijer - [email protected]; Eric CM van Gorp - [email protected]; Dees PM Brandjes - [email protected]; Marcel Levi - [email protected]; Harry R Büller - [email protected] * Corresponding author
Published: 16 October 2007 Thrombosis Journal 2007, 5:16
doi:10.1186/1477-9560-5-16
Received: 12 February 2007 Accepted: 16 October 2007
This article is available from: http://www.thrombosisjournal.com/content/5/1/16 © 2007 van Wissen et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract Background: Influenza infections have been associated with procoagulant changes. Whether influenza infections lead to an increased risk of pulmonary embolism remains to be established. Methods: We conducted a nested case control study in a large cohort of patients with a clinical suspicion of having pulmonary embolism. Blood samples were collected to investigate the presence of influenza A and B by complement fixation assay (CFA). We compared case patients, in whom pulmonary embolism was proven (n = 102), to controls, in whom pulmonary embolism was excluded (n = 395). Furthermore, we compared symptoms of influenza-like illness in both patient groups 2 weeks prior to inclusion in the study, using the influenza-like illness (ILI) score, which is based on a questionnaire. We calculated the risk of pulmonary embolism associated with influenza infection. Results: The percentage of patients with influenza A was higher in the control group compared to the case group (4.3% versus 1.0%, respectively, odds ratio 0.22; 95% CI: 0.03–1.72). Influenza B was not detectable in any of the cases and was found in 3 of the 395 controls (0.8%). The ILI score was positive in 24% of the cases and 25% in the control persons (odds ratio 1.16, 95% CI: 0.67–2.01). We did not observe an association between the ILI score and proven influenza infection. Conclusion: In this clinical study, influenza infection was not associated with an increased risk of acute pulmonary embolism. The ILI score is non-specific in this clinical setting.
Background Deep vein thrombosis and pul
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