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. 2018 Apr 17;2(2):199-208.
doi: 10.1002/rth2.12101. eCollection 2018 Apr.

Current and future burden of venous thrombosis: Not simply predictable

Luuk J J Scheres  1   2 , Willem M Lijfering  1 , Suzanne C Cannegieter  1   3
Affiliations

Current and future burden of venous thrombosis: Not simply predictable

Luuk J J Scheres et al. Res Pract Thromb Haemost. .

Abstract

Venous thrombosis is a major contributor to the global disease burden. In this review we aim to answer two important questions: (1) are we making progress in reducing this disease burden and (2) how can we further improve? To answer these questions, we first evaluated the disease burden, that is, the incidence of first venous thrombosis over the past decade(s) and discuss its most important determinants. We found that the incidence of first venous thrombosis remained relatively unchanged, despite an increase in risk factor prevalence and a rise in identification of subsegmental pulmonary emboli due to enhanced image quality and utilization. This is, however, balanced by improved thromboprophylaxis strategies, resulting in an overall unchanged venous thrombosis incidence. We can further improve by developing, validating, and implementing risk assessment strategies, allowing us to identify persons at high or low risk in whom thromboprophylaxis can be provided or withheld, respectively.

Keywords: epidemiology; incidence; risk assessment; risk factors; venous thrombosis.

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Figures

Figure 1
Figure 1
Absolute risk of first venous thrombosis over the course of time in three independent studies. Age‐adjusted incidence rates of first venous thrombosis: A, among Olmsted County, Minnesota residents, 1981‐2010 based on 3293 events as published by Heit and colleagues,3 printed with permission from Schattauer publishers; B, among residents of Worcester, Massachusetts, 1985‐2009 based on 3887 events, printed with permission of Elsevier as published by Huang and colleagues20; and C, over the course of 10 years in three large anticoagulation clinics in the Netherlands, adapted from Scheres et al.,24 based on 14 253 events
Figure 2
Figure 2
Trends in the prevalence of several risk factors for venous thrombosis, 1995‐2010. *Reference is 1995 except for contraceptives (oral or injectable) where the reference year is 1998. A denotes, major medical conditions; B, demographics and lifestyle; C, surgery (all) and orthopedic surgery; D, female‐specific risk factors. Adapted from statistics Netherlands,17, 26, 27, 28, 29, 30 Royal Schiphol Group,31 and Netherlands Comprehensive Cancer Organisation.32 Precise numbers are available in Table S1
Figure 3
Figure 3
Absolute risk of first deep vein thrombosis and pulmonary embolism over the course of time in three large anticoagulation clinics in the Netherlands. Incidence of first pulmonary embolism and deep vein thrombosis over the course of 10 years in three large anticoagulation clinics in the Netherlands24
See this image and copyright information in PMC

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