Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2014 Sep;127(9):829-39.e5.
doi: 10.1016/j.amjmed.2014.03.041. Epub 2014 May 6.

Secular trends in occurrence of acute venous thromboembolism: the Worcester VTE study (1985-2009)

Wei Huang  1 , Robert J Goldberg  2 , Frederick A Anderson  3 , Catarina I Kiefe  2 , Frederick A Spencer  4
Affiliations

Secular trends in occurrence of acute venous thromboembolism: the Worcester VTE study (1985-2009)

Wei Huang et al. Am J Med. 2014 Sep.

Abstract

Background: The clinical epidemiology of venous thromboembolism has changed recently because of advances in identification, prophylaxis, and treatment. We sought to describe secular trends in the occurrence of venous thromboembolism among residents of the Worcester, Massachusetts, metropolitan statistical area.

Methods: Population-based methods were used to monitor trends in event rates of first-time or recurrent venous thromboembolism in 5025 Worcester, Massachusetts, metropolitan statistical area residents who were diagnosed with acute pulmonary embolism or lower-extremity deep vein thrombosis during 9 annual periods between 1985 and 2009. Medical records were reviewed by abstractors and validated by clinicians.

Results: Age- and sex-adjusted annual event rates for first-time venous thromboembolism increased from 73 (95% confidence interval [CI], 64-82) per 100,000 in 1985/1986 to 133 (CI, 122-143) in 2009, primarily because of an increase in pulmonary embolism. The rate of recurrent venous thromboembolism decreased from 39 (CI, 32-45) in 1985/1986 to 19 (CI, 15-23) in 2003, and then increased to 35 (CI, 29-40) in 2009. There was an increasing trend in using noninvasive diagnostic testing, with approximately half of tests being invasive in 1985/1986 and almost all noninvasive by 2009.

Conclusions: Despite advances in identification, prophylaxis, and treatment between 1985 and 2009, the annual event rate of venous thromboembolism has increased and remains high. Although these increases partially may be due to increased sensitivity of diagnostic methods, especially for pulmonary embolism, they also may imply that current prevention and treatment strategies are less than optimal.

Keywords: Incidence; Outcomes research; Pulmonary embolism; Venous thromboembolism; Venous thrombosis.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: FAA has received research grants from Sanofi and The Medicines Company. He has served as a consultant to GlaxoSmithKline and Millennium on the design of outcomes studies. Others have no conflict of interest.

Figures

Figure 1
Figure 1
Age- and sex-adjusted annual event rates of (a) first-time and (b) recurrent clinical recognized acute venous thromboembolism among residents of Worcester, Massachusetts, metropolitan statistical area (1985 to 2009).
See this image and copyright information in PMC

References

    1. Colman RW, Marder VJ, Clowes AW, George JN, Goldhaber sZ. Hemostasis and Thrombosis Basic Principles and Clinical Practice. 5. Vol. 1. Lippincott Williams & Wilkins; 2006.
    1. Gillum RF. Pulmonary embolism and thrombophlebitis in the United States, 1970–1985. Am Heart J. 1987 Nov;114(5):1262–1264. - PubMed
    1. Raskob GE, Silverstein R, Bratzler DW, Heit JA, White RH. Surveillance for deep vein thrombosis and pulmonary embolism: recommendations from a national workshop. Am J Prev Med. 2010 Apr;38(4 Suppl):S502–509. - PubMed
    1. Emadi A, Streiff M. Diagnosis and management of venous thromboembolism: an update a decade into the new millennium. Arch Iran Med. 2011 Sep;14(5):341–351. - PubMed
    1. Martinez-Murillo C, Aguilar-Arteaga ML, Velasco-Ortega E, et al. Clinical guideline for diagnosis and treatment of the thromboembolic venous disease. Rev Med Inst Mex Seguro Soc. 2011 Jul-Aug;49(4):437–449. - PubMed

Publication types