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. 2024 Dec 1;16(12):e74925.
doi: 10.7759/cureus.74925. eCollection 2024 Dec.

Trends in the Epidemiology of Deep Vein Thrombosis and Pulmonary Embolism in Patients Undergoing Surgery

Shelby Cowan  1 , Kassem Ghayyad  1 , Matthew J Conlon  1 , Maya Naik  1 , Ibrahim Zeini  1 , Michael Hawks  1 , Atif Ahmed  1 , Amir R Kachooei  2   3   4
Affiliations

Trends in the Epidemiology of Deep Vein Thrombosis and Pulmonary Embolism in Patients Undergoing Surgery

Shelby Cowan et al. Cureus. .

Abstract

Objective This study aims to utilize the TriNetX database, a comprehensive global network, to improve our understanding of the frequency, demographic factors, and related comorbidities of surgical patients who develop venous thromboembolism (VTEs) events. Methods The global collaborative network in TriNetX was queried for all cases from January 1, 2017, through December 31, 2023. International Classification for Disease (ICD) diagnosis codes were used to define patient cohorts with deep vein thrombosis (DVT) of the upper or lower extremity or pulmonary embolism (PE). Patient information was extracted including age, sex, ethnicity, race status, and comorbidities. We assumed that PE occurred following a DVT which is only reported once as a PE, and not a DVT. Results The study included 414,045 patients with lower extremity DVT, 82,800 with upper extremity DVT, and 508,044 with reported PE following a DVT. DVT and PE account for approximately 51% and 49% of VTE cases, respectively, with differences noted based on age, sex, ethnicity, race, and comorbidities. The data showed that advanced age, higher BMI, and Black race are associated with a higher risk of thromboembolism. Common comorbidities, such as cardiac dysrhythmias, a history of thromboembolism, cancer, and renal failure are prevalent across all three diagnostic groups. Conclusion The study results suggest that the incidence and prevalence of VTE are changing due to the aging population and changes in demographic patterns. Healthcare services should consider planning for the changes in morbidity, mortality, and related healthcare costs. Surgical patients with multiple related comorbidities should be managed to prevent VTEs more aggressively with close monitoring for any evolving VTE.

Keywords: deep vein thrombosis (dvt); factor v leiden deficiency; lower extremity dvt; medical comorbidities; upper extremity dvt; venous thromboembolism (vte); vte prophylaxis.

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Conflict of interest statement

Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Bar Graph Showing Incidence of Lower Extremity Deep Vein Thrombosis (LE DVT), Upper Extremity Deep Vein Thrombosis (UE DVT), and Pulmonary Embolism (PE) From 2017 to 2023
Figure 2
Figure 2. Bar Graph Showing Proportion of Lower Extremity Deep Vein Thrombosis (LE DVT), Upper Extremity Deep Vein Thrombosis (UE DVT), and Pulmonary Embolism (PE) Cases by Age Group
Figure 3
Figure 3. Bar Graph Showing the Percentage of Lower Extremity Deep Vein Thrombosis (LE DVT), Upper Extremity Deep Vein Thrombosis (UE DVT), and Pulmonary Embolism (PE) Cases by Sex
Figure 4
Figure 4. Bar Graph Showing the Percentage of Lower Extremity Deep Vein Thrombosis (LE DVT), Upper Extremity Deep Vein Thrombosis (UE DVT), and Pulmonary Embolism (PE) Cases by Race
Figure 5
Figure 5. Bar Graph Depicting the Proportion of Patients With Lower Extremity Deep Vein Thrombosis (LE DVT), Upper Extremity Deep Vein Thrombosis (UE DVT), and Pulmonary Embolism (PE) Who Have Comorbidities Related to Coagulation
Figure 6
Figure 6. Bar Graph Showing the Percentage of Lower Extremity Deep Vein Thrombosis (LE DVT), Upper Extremity Deep Vein Thrombosis (UE DVT), and Pulmonary Embolism (PE) Patients With Certain Cardiovascular Comorbidities
Figure 7
Figure 7. Bar Graph Showing the Proportion of Lower Extremity Deep Vein Thrombosis (LE DVT), Upper Extremity Deep Vein Thrombosis (UE DVT), and Pulmonary Embolism (PE) Patients With Additional Comorbidities
DM with Cxs: diabetes mellitus with complications; IBD: inflammatory bowel disease
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