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. 2018 Oct;131(10):1200-1208.
doi: 10.1016/j.amjmed.2018.04.033. Epub 2018 Jun 23.

National and Regional Trends in Deep Vein Thrombosis Hospitalization Rates, Discharge Disposition, and Outcomes for Medicare Beneficiaries

Karl E Minges  1 , Behnood Bikdeli  2 , Yun Wang  3 , Robert R Attaran  4 , Harlan M Krumholz  5
Affiliations

National and Regional Trends in Deep Vein Thrombosis Hospitalization Rates, Discharge Disposition, and Outcomes for Medicare Beneficiaries

Karl E Minges et al. Am J Med. 2018 Oct.

Abstract

Introduction: Older adults are at increased risk of developing deep vein thrombosis. Little is known about national trends of deep vein thrombosis hospitalizations in the context of primary and secondary prevention efforts.

Methods: Medicare standard analytic files were analyzed from 2015-2017 to identify Fee-For-Service patients aged ≥65 years who had a principal discharge diagnosis for deep vein thrombosis from 1999 to 2010. We reported the deep vein thrombosis hospitalization rates per 100,000 person-years as well as 30-day and 1-year mortality rates. We used mixed-effects models to calculate adjusted outcomes.

Results: Overall, there were 726,423 deep vein thrombosis hospitalizations in Medicare Fee-for-Service from 1999 to 2010. Deep vein thrombosis hospitalization rate adjusted for age, sex, and race decreased from 264 per 100,000 person-years in 1999 to 167 per 100,000 person-years in 2010, a relative decline of 36.7% (P < .0001). Hospitalizations decreased for all subgroups by age, sex, and race with the exception of black patients (316 to 382 per 100,000 person-years, a relative increase of 20.8%) (P < .0001). Hospital length of stay decreased from 6.1 days in 1999 to 5.0 days in 2010, and the proportion of patients discharged to home decreased from 57.2% to 44.1%. Risk-adjusted 30-day, 6-month, and 1-year mortality and 30-day readmission rates remained relatively stable across the study period, but were highest among women in recent years.

Conclusions: The overall deep vein thrombosis hospitalization rate decreased from 1999 to 2010, except for black patients. Decreases in hospitalizations may reflect changes in clinical practice with increased outpatient rather than inpatient management, and faster transitions to outpatient care for management of deep vein thrombosis.

Keywords: Deep vein thrombosis; Health care disparities; Health care utilization; Hospitalization; Medicare.

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Conflict of interest statement

Conflicts of Interest: BB is supported by the National Heart, Lung, and Blood Institute, National Institutes of Health (NIH) through grant number T32 HL007854. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. BB and HMK report that they were approached by lawyers on behalf of plaintiffs in litigation related to IVC filters, although this study was conducted prior to that relationship. The current study is the idea of the investigators and not performed at the request or support of a third party. HMK is a recipient of research grants, through Yale, from Medtronic and Johnson & Johnson (Janssen) to develop methods of clinical trial data sharing and from Medtronic and the U.S. Food and Drug Administration to develop methods for post-market surveillance of medical devices; works under contract with the Centers for Medicare & Medicaid Services to develop and maintain performance measures that are publicly reported; chairs a Cardiac Scientific Advisory Board for UnitedHealth; is a participant/participant representative of the IBM Watson Health Life Sciences Board; is a member of the Advisory Board for Element Science and the Physician Advisory Board for Aetna; and is the founder of Hugo, a personal health information platform. KEM, YW, and RRA have no conflicts, financial or otherwise, to disclose.

Figures

Figure 1
Figure 1
Rates of adjusted hospitalization for deep vein thrombosis by overall and race subgroup, 1999 to 2010.
Figure 2
Figure 2
Hospitalization rates per 100,000 person-years for deep vein thrombosis by US State, 1999 (top) and 2010 (bottom).
See this image and copyright information in PMC

References

    1. Goldhaber SZ, Turpie AGG. Prevention of venous thromboembolism among hospitalized medical patients. Circulation. 2005; 111(l):e1–e3. - PubMed
    1. Heit JA, O’Fallon WM, Petterson TM, et al. Relative impact of risk factors for deep vein thrombosis and pulmonary embolism: a population-based study. Arch Intern Med. 2002;162(11): 1245–1248. - PubMed
    1. Martinez C, Cohen AT, Bamber L, Rietbrock S. Epidemiology of first and recurrent venous thromboembolism: a population-based cohort study in patients without active cancer. Thromb Haemost. 2014;112 (2):255–263. - PubMed
    1. Heit JA, Spencer FA, White RH. The epidemiology of venous thromboembolism. J Thromb Thrombolysis. 2016;41(1):3–14. - PMC - PubMed
    1. Kesieme E, Kesieme C, Jebbin N, et al. Deep vein thrombosis: a clinical review. J Blood Med. 2011; 2:59–69. - PMC - PubMed

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