Incidence of Venous Thromboembolism in a Racially Diverse Population of Oklahoma County, Oklahoma

Abstract

Background: Contemporary incidence data for venous thromboembolism (VTE) from racially diverse populations are limited. The racial distribution of Oklahoma County closely mirrors that of the United States.

Objective: To evaluate VTE incidence and mortality, including demographic and racial subgroups.

Design: Population-based prospective study.

Setting: We conducted VTE surveillance at all relevant tertiary care facilities and outpatient clinics in Oklahoma County, Oklahoma during 2012 to 2014, using both active and passive methods. Active surveillance involved reviewing all imaging reports used to diagnose VTE. Passive surveillance entailed identifying VTE events from hospital discharge data and death certificate records.

Measurements: We used Poisson regression to calculate crude, age-stratified, and age-adjusted incidence and mortality rates per 1,000 population per year and 95% confidence intervals (CIs).

Results: The incidence rate of all VTE was 3.02 (2.92-3.12) for those age ≥18 years and 0.05 (0.04-0.08) for those <18 years. The age-adjusted incidence rates of all VTE, deep vein thrombosis, and pulmonary embolism were 2.47 (95% CI: 2.39-2.55), 1.47 (1.41-1.54), and 0.99 (0.93-1.04), respectively. The age-adjusted VTE incidence and the 30-day mortality rates, respectively, were 0.63 and 0.121 for Asians/Pacific Islanders, 3.25 and 0.355 for blacks, 0.67 and 0.111 for Hispanics, 1.25 and 0.195 for Native Americans, and 2.71 and 0.396 for whites.

Conclusion: The age-adjusted VTE incidence and mortality rates vary substantially by race. The incidence of three per 1,000 adults per year indicates an important disease burden, and is informative of the burden in the U.S.

Fig. 1

Cumulative incidence of the first recurrent venous thromboembolic event ( n  = 324) detected during the surveillance period (April 1, 2012–March 31, 2014) among all incident events ( n  = 3,251 ^a ), stratified by provoked status ^b . ^a Among the 3,255 incident VTE events, four were excluded because of insufficient information to calculate time to recurrence between first and second observed episodes during the surveillance window. ^b Unprovoked: 137 (9.3%) recurrent events of 1,469; transient provoked: 136 (9.6%) recurrent events of 1,411; persistent provoked: 51 (13.7%) recurrent events of 371.