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A Population-Based Perspective of the Hospital Incidence and Case-Fatality Rates of Deep Vein Thrombosis and Pulmonary Embolism: The Worcester DVT Study

A Population-Based Perspective of the Hospital Incidence and Case-Fatality Rates of Deep Vein... Abstract A community-wide study was conducted in 16 short-stay hospitals in metropolitan Worcester, Mass, to examine the incidence and case-fatality rates of deep vein thrombosis and pulmonary embolism in patients hospitalized between July 1, 1985, and December 31, 1986. The average annual incidence of deep vein thrombosis alone was 48 per 100000, while the incidence of pulmonary embolism with or without deep vein thrombosis was 23 per 100 000. The incidence rates of deep vein thrombosis and pulmonary embolism increased exponentially with age. The inhospital case-fatality rate of venous thromboembolism was 12%. Among patients discharged from the hospital, the long-term case-fatality rates were 19%, 25%, and 30% at 1, 2, and 3 years after hospital discharge. Extrapolation of the data from this population-based study suggests that there are approximately 170 000 new cases of clinically recognized venous thromboembolism in patients treated in short-stay hospitals in the United States each year, and 99 000 hospitalizations for recurrent disease. Because of the silent nature of this disease and the low rate of autopsy in the United States, the total incidence, prevalence, and mortality rates of venous thromboembolism remain elusive. (Arch Intern Med. 1991;151:933-938) References 1. Bergqvist D. Postoperative Thromboembolism . Berlin, Germany: Springer-Verlag; 1983:11-30. 2. Carter C, Gent M. The epidemiology of venous thrombosis . In: Colman RW, Hirsh J, Marder VJ, Salzman EW, eds. Hemostasis and Thrombosis . Philadelphia, Pa: JB Lippincott; 1982:805-819. 3. Haeger K. Problems of acute deep venous thrombosis, I: the interpretation of signs and symptoms . Angiology. 1969;20:219-223.Crossref 4. Hirsh J, Genton E, Hull R. Venous Thromboembolism . New York, NY: Grune & Stratton; 1981:1. 5. Hume M, Sevitt S, Thomas DP. Venous Thrombosis and Pulmonary Embolism . Cambridge, Mass: Harvard University Press; 1970:1-24. 6. McLachlin J, Richards T, Paterson JC. An evaluation of clinical signs in the diagnosis of venous thrombosis . Arch Surg. 1962;85:738-744.Crossref 7. Morrell MT, Dunnill MS. The post-mortem incidence of pulmonary embolism in a hospital population . Br J Surg. 1968;55:347-352.Crossref 8. Dalen, JE, Alpert, JS. Natural history of pulmonary embolism . Prog Cardiovasc Dis. 1975;17:257-270.Crossref 9. American Medical Association. AMA Height-Weight Tables . Chicago, Ill: American Medical Association; 1975. 10. SAS Institute. SAS User's Guide: Statistics, Version 6. Cary, NC: SAS Institute; 1985. 11. Lawless, JF. Statistical Models and Methods for Lifetime Data . New York, NY: John Wiley & Sons Inc; 1982:53-70. 12. Breslow NE, Day NE. Statistical Methods in Cancer Research, I: The Design and Analysis of Cohort Studies . New York, NY: Oxford University PressInc;1987. 13. Hosmer DW, Lemeshow S. Applied Logistic Regression . New York, NY: John Wiley & Sons Inc; 1989. 14. Goldhaber SZ, Hennekens CH, Evans DA, Newton EC, Godleski JJ. Factors associated with an antemortem diagnosis of major pulmonary embolism . Am JMed. 1982;73:822-826. 15. Hull RL, Hirsh J, Sackett DL, Stoddart G. Cost effectiveness of clinical diagnosis, venography and noninvasive testing in patients with symptomatic deep-vein thrombosis . N Engl J Med. 1981;304:1561-1567.Crossref 16. Consensus conference: prevention of venous thromboembolism and pulmonary embolism . JAMA. 1986;256:744-749.Crossref 17. Coon WW, Willis PW, Keller JB. Venous thromboembolism and other venous disease in the Tecumseh community health study . Circulation. 1973;48:839-846.Crossref 18. Gillum RF. Pulmonary embolism in the United States, 1970-1985 . Am Heart J. 1987;113:1262-1264.Crossref 19. Goldhaber SZ, Hennekens CH. Time trends in hospital mortality and diagnosis of pulmonary embolism . Am Heart J. 1982;104:305-306.Crossref 20. Nicolaides AN, Irving D. Clinical factors and the risk of deep venous thrombosis . In: Nicolaides AN, ed. Thromboembolism Etiology, Advances in Prevention and Management . Baltimore, Md: University Park; 1975:199-204. 21. Wolf WG, Sabiston DC. Pulmonary Embolism . Philadelphia, Pa: WB Saunders Co; 1980:13. 22. Hill RB, Anderson RE. The Autopsy: Medical Practice and Public Policy . Woburn, Mass: Butterworths; 1988:153. 23. Dismuke SE, Wanger EH. Pulmonary embolism as a cause of death: the changing mortality in hospitalized patients . JAMA. 1986;255:2039-2042.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

A Population-Based Perspective of the Hospital Incidence and Case-Fatality Rates of Deep Vein Thrombosis and Pulmonary Embolism: The Worcester DVT Study

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Publisher
American Medical Association
Copyright
Copyright © 1991 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1991.00400050081016
Publisher site
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Abstract

Abstract A community-wide study was conducted in 16 short-stay hospitals in metropolitan Worcester, Mass, to examine the incidence and case-fatality rates of deep vein thrombosis and pulmonary embolism in patients hospitalized between July 1, 1985, and December 31, 1986. The average annual incidence of deep vein thrombosis alone was 48 per 100000, while the incidence of pulmonary embolism with or without deep vein thrombosis was 23 per 100 000. The incidence rates of deep vein thrombosis and pulmonary embolism increased exponentially with age. The inhospital case-fatality rate of venous thromboembolism was 12%. Among patients discharged from the hospital, the long-term case-fatality rates were 19%, 25%, and 30% at 1, 2, and 3 years after hospital discharge. Extrapolation of the data from this population-based study suggests that there are approximately 170 000 new cases of clinically recognized venous thromboembolism in patients treated in short-stay hospitals in the United States each year, and 99 000 hospitalizations for recurrent disease. Because of the silent nature of this disease and the low rate of autopsy in the United States, the total incidence, prevalence, and mortality rates of venous thromboembolism remain elusive. (Arch Intern Med. 1991;151:933-938) References 1. Bergqvist D. Postoperative Thromboembolism . Berlin, Germany: Springer-Verlag; 1983:11-30. 2. Carter C, Gent M. The epidemiology of venous thrombosis . In: Colman RW, Hirsh J, Marder VJ, Salzman EW, eds. Hemostasis and Thrombosis . Philadelphia, Pa: JB Lippincott; 1982:805-819. 3. Haeger K. Problems of acute deep venous thrombosis, I: the interpretation of signs and symptoms . Angiology. 1969;20:219-223.Crossref 4. Hirsh J, Genton E, Hull R. Venous Thromboembolism . New York, NY: Grune & Stratton; 1981:1. 5. Hume M, Sevitt S, Thomas DP. Venous Thrombosis and Pulmonary Embolism . Cambridge, Mass: Harvard University Press; 1970:1-24. 6. McLachlin J, Richards T, Paterson JC. An evaluation of clinical signs in the diagnosis of venous thrombosis . Arch Surg. 1962;85:738-744.Crossref 7. Morrell MT, Dunnill MS. The post-mortem incidence of pulmonary embolism in a hospital population . Br J Surg. 1968;55:347-352.Crossref 8. Dalen, JE, Alpert, JS. Natural history of pulmonary embolism . Prog Cardiovasc Dis. 1975;17:257-270.Crossref 9. American Medical Association. AMA Height-Weight Tables . Chicago, Ill: American Medical Association; 1975. 10. SAS Institute. SAS User's Guide: Statistics, Version 6. Cary, NC: SAS Institute; 1985. 11. Lawless, JF. Statistical Models and Methods for Lifetime Data . New York, NY: John Wiley & Sons Inc; 1982:53-70. 12. Breslow NE, Day NE. Statistical Methods in Cancer Research, I: The Design and Analysis of Cohort Studies . New York, NY: Oxford University PressInc;1987. 13. Hosmer DW, Lemeshow S. Applied Logistic Regression . New York, NY: John Wiley & Sons Inc; 1989. 14. Goldhaber SZ, Hennekens CH, Evans DA, Newton EC, Godleski JJ. Factors associated with an antemortem diagnosis of major pulmonary embolism . Am JMed. 1982;73:822-826. 15. Hull RL, Hirsh J, Sackett DL, Stoddart G. Cost effectiveness of clinical diagnosis, venography and noninvasive testing in patients with symptomatic deep-vein thrombosis . N Engl J Med. 1981;304:1561-1567.Crossref 16. Consensus conference: prevention of venous thromboembolism and pulmonary embolism . JAMA. 1986;256:744-749.Crossref 17. Coon WW, Willis PW, Keller JB. Venous thromboembolism and other venous disease in the Tecumseh community health study . Circulation. 1973;48:839-846.Crossref 18. Gillum RF. Pulmonary embolism in the United States, 1970-1985 . Am Heart J. 1987;113:1262-1264.Crossref 19. Goldhaber SZ, Hennekens CH. Time trends in hospital mortality and diagnosis of pulmonary embolism . Am Heart J. 1982;104:305-306.Crossref 20. Nicolaides AN, Irving D. Clinical factors and the risk of deep venous thrombosis . In: Nicolaides AN, ed. Thromboembolism Etiology, Advances in Prevention and Management . Baltimore, Md: University Park; 1975:199-204. 21. Wolf WG, Sabiston DC. Pulmonary Embolism . Philadelphia, Pa: WB Saunders Co; 1980:13. 22. Hill RB, Anderson RE. The Autopsy: Medical Practice and Public Policy . Woburn, Mass: Butterworths; 1988:153. 23. Dismuke SE, Wanger EH. Pulmonary embolism as a cause of death: the changing mortality in hospitalized patients . JAMA. 1986;255:2039-2042.Crossref

Journal

Archives of Internal Medicine – American Medical Association

Published: May 1, 1991

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