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Comparative Study
. 2009 Nov;28(4):401-9.
doi: 10.1007/s11239-009-0378-3.

Incidence rates, clinical profile, and outcomes of patients with venous thromboembolism. The Worcester VTE study

Frederick A Spencer  1 , Cathy Emery, Samuel W Joffe, Luigi Pacifico, Darleen Lessard, George Reed, Joel M Gore, Robert J Goldberg
Affiliations
Comparative Study

Incidence rates, clinical profile, and outcomes of patients with venous thromboembolism. The Worcester VTE study

Frederick A Spencer et al. J Thromb Thrombolysis. 2009 Nov.

Abstract

While there have been advances in prophylaxis and management of venous thromboembolism (VTE), there are a dearth of data from the perspective of a community-wide study, on the epidemiology, management, and outcomes of patients with a first episode of deep vein thrombosis (DVT) or pulmonary embolism (PE). The purpose of this population-based observational study was to describe trends in the incidence rates, clinical profile, management, and outcomes for patients with VTE. The medical records of Worcester (MA) metropolitan area residents with ICD-9 codes consistent with possible VTE during 1999, 2001, and 2003 were independently validated and reviewed by trained abstractors. A total of 1,567 persons with first-time VTE were identified. Incidence rates (per 100,000) of VTE were stable between 1999 (109) and 2003 (117). A considerable proportion of patients treated for VTE had events of unclear clinical significance (e.g., isolated calf DVT, unconfirmed "possible" PE). By 2003, low-molecular-weight heparin was increasingly utilized as acute therapy and more than 25% of patients with VTE were managed as outpatients. Cumulative rates of recurrent VTE and major bleeding following initial VTE were high (approximately 16% and 12%, respectively, mean follow-up 1,216 days) and did not change significantly between 1999 and 2003. Our data suggest that while the incidence rates of VTE remain high, and outcomes suboptimal, there have been marked changes in its management. Whether these changes will result in future declines in VTE incidence and/or improved outcomes in the community setting will require further surveillance.

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Figures

Figure 1
Figure 1
Rate of recurrent VTE after initial VTE stratified according to year of diagnosis
Figure 2
Figure 2
Rate of major bleeding after initial VTE stratified according to year of diagnosis
Figure 3
Figure 3
Mortality after initial VTE stratified according to year of diagnosis
See this image and copyright information in PMC

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