Pulmonary embolism epidemiology and demographics: Difference between revisions
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==Overview== | ==Overview== | ||
The precise number of people affected by venous thromboembolism (VTE), that is either [[deep vein thrombosis]], pulmonary embolism (PE), or both, is unknown, but estimates range from 300,000 to 600,000 (1 to 2 per 1,000, and in those over 80 years of age, as high as 1 in 100) each year in the United States | The precise number of people affected by [[venous thromboembolism]](VTE), that is either [[deep vein thrombosis]], pulmonary embolism (PE), or both, is unknown, but estimates range from 300,000 to 600,000 (1 to 2 per 1,000, and in those over 80 years of age, as high as 1 in 100) each year in the United States. Approximately 5 to 8% of the U.S. population has one of several [[genetic]] risk factors, also known as [[inherited]] [[thrombophilia]]s in which a [[genetic]] defect can be identified that increases the risk for [[thrombosis]].<ref name=CDC>[http://www.cdc.gov/ncbddd/dvt/data.html CDC- Deep Vein Thrombosis (DVT) / Pulmonary Embolism (PE) — Blood Clot Forming in a Vein]</ref><ref name="pmid20331949">{{cite journal| author=Beckman MG, Hooper WC, Critchley SE, Ortel TL| title=Venous thromboembolism: a public health concern. | journal=Am J Prev Med | year= 2010 | volume= 38 | issue= 4 Suppl | pages= S495-501 | pmid=20331949 | doi=10.1016/j.amepre.2009.12.017 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20331949 }} </ref> | ||
==Epidemiology and Demographics== | ==Epidemiology and Demographics== | ||
===Incidence=== | ===Incidence=== | ||
The precise number of people affected by venous thromboembolism (VTE), that is either deep vein thrombosis (DVT), [[pulmonary embolism]] (PE), or both, is unknown, but estimates range from 300,000 to 600,000 (1 to 2 per 1,000, and in those over 80 years of age, as high as 1 in 100) each year in the United States.<ref>[http://www.cdc.gov/ncbddd/dvt/data.html CDC- Deep Vein Thrombosis (DVT) / Pulmonary Embolism (PE) — Blood Clot Forming in a Vein]</ref><ref name="pmid20331949">{{cite journal| author=Beckman MG, Hooper WC, Critchley SE, Ortel TL| title=Venous thromboembolism: a public health concern. | journal=Am J Prev Med | year= 2010 | volume= 38 | issue= 4 Suppl | pages= S495-501 | pmid=20331949 | doi=10.1016/j.amepre.2009.12.017 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20331949 }} </ref> | * The precise number of people affected by [[venous thromboembolism]] (VTE), that is either [[deep vein thrombosis]] (DVT), [[pulmonary embolism]] (PE), or both, is unknown, but estimates range from 300,000 to 600,000 (1 to 2 per 1,000, and in those over 80 years of age, as high as 1 in 100) each year in the United States.<ref name=CDC>[http://www.cdc.gov/ncbddd/dvt/data.html CDC- Deep Vein Thrombosis (DVT) / Pulmonary Embolism (PE) — Blood Clot Forming in a Vein]</ref><ref name="pmid20331949">{{cite journal| author=Beckman MG, Hooper WC, Critchley SE, Ortel TL| title=Venous thromboembolism: a public health concern. | journal=Am J Prev Med | year= 2010 | volume= 38 | issue= 4 Suppl | pages= S495-501 | pmid=20331949 | doi=10.1016/j.amepre.2009.12.017 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20331949 }} </ref> | ||
* In the United States, the annual incidence of VTE is estimated to be approximately 100 per 100,000 persons.<ref name="pmid12814979">{{cite journal |author=White RH |title=The epidemiology of venous thromboembolism |journal=Circulation |volume=107 |issue=23 Suppl 1 |pages=I4–8 |year=2003 |month=June |pmid=12814979 |doi=10.1161/01.CIR.0000078468.11849.66 |url=}}</ref> | |||
===Age=== | ===Age=== | ||
The incidence of VTE increases with age, ranging from | The incidence of [[VTE]] increases with age, ranging from < 5 cases per 100,000 people in childhood to 500 cases per 100,000 people in the elderly.<ref name="pmid12814979">{{cite journal |author=White RH |title=The epidemiology of venous thromboembolism |journal=Circulation |volume=107 |issue=23 Suppl 1 |pages=I4–8 |year=2003 |month=June |pmid=12814979 |doi=10.1161/01.CIR.0000078468.11849.66 |url=}}</ref> Subjects who are more than 65 years of age are at three times higher risk for VTE compared to those who are 45-54 years old.<ref name="pmid15210384">{{cite journal| author=Cushman M, Tsai AW, White RH, Heckbert SR, Rosamond WD, Enright P et al.| title=Deep vein thrombosis and pulmonary embolism in two cohorts: the longitudinal investigation of thromboembolism etiology. | journal=Am J Med | year= 2004 | volume= 117 | issue= 1 | pages= 19-25 | pmid=15210384 | doi=10.1016/j.amjmed.2004.01.018 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15210384 }} </ref> | ||
===Gender=== | ===Gender=== | ||
Studies about differences in the incidence of VTE by gender have mixed results.<ref name="pmid9521222">{{cite journal |author=Silverstein MD, Heit JA, Mohr DN, Petterson TM, O'Fallon WM, Melton LJ |title=Trends in the incidence of deep vein thrombosis and pulmonary embolism: a 25-year population-based study |journal=Arch. Intern. Med. |volume=158 |issue=6 |pages=585–93 |year=1998 |month=March |pmid=9521222 |doi= |url=}}</ref><ref name="pmid8154949">{{cite journal |author=Kniffin WD, Baron JA, Barrett J, Birkmeyer JD, Anderson FA |title=The epidemiology of diagnosed pulmonary embolism and deep venous thrombosis in the elderly |journal=Arch. Intern. Med. |volume=154 |issue=8 |pages=861–6 |year=1994 |month=April |pmid=8154949 |doi= |url=}}</ref><ref name="pmid15210384">{{cite journal |author=Cushman M, Tsai AW, White RH, ''et al.'' |title=Deep vein thrombosis and pulmonary embolism in two cohorts: the longitudinal investigation of thromboembolism etiology |journal=Am. J. Med. |volume=117 |issue=1 |pages=19–25 |year=2004 |month=July |pmid=15210384 |doi=10.1016/j.amjmed.2004.01.018 |url=}}</ref><ref name="urlVenous Thromboembolism in Adult Hospitalizations — United States, 2007–2009">{{cite web |url=http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6122a1.htm?s_cid=mm6122a1_w |title=Venous Thromboembolism in Adult Hospitalizations — United States, 2007–2009 |format= |work= |accessdate=2012-10-06}}</ref> In addition, the risk for VTE was reported to consistently increase with age across both genders.<ref name="pmid15210384">{{cite journal |author=Cushman M, Tsai AW, White RH, ''et al.'' |title=Deep vein thrombosis and pulmonary embolism in two cohorts: the longitudinal investigation of thromboembolism etiology |journal=Am. J. Med. |volume=117 |issue=1 |pages=19–25 |year=2004 |month=July |pmid=15210384 |doi=10.1016/j.amjmed.2004.01.018 |url=}}</ref> | Studies about differences in the incidence of [[VTE]] by gender have mixed results.<ref name="pmid9521222">{{cite journal |author=Silverstein MD, Heit JA, Mohr DN, Petterson TM, O'Fallon WM, Melton LJ |title=Trends in the incidence of deep vein thrombosis and pulmonary embolism: a 25-year population-based study |journal=Arch. Intern. Med. |volume=158 |issue=6 |pages=585–93 |year=1998 |month=March |pmid=9521222 |doi= |url=}}</ref><ref name="pmid8154949">{{cite journal |author=Kniffin WD, Baron JA, Barrett J, Birkmeyer JD, Anderson FA |title=The epidemiology of diagnosed pulmonary embolism and deep venous thrombosis in the elderly |journal=Arch. Intern. Med. |volume=154 |issue=8 |pages=861–6 |year=1994 |month=April |pmid=8154949 |doi= |url=}}</ref><ref name="pmid15210384">{{cite journal |author=Cushman M, Tsai AW, White RH, ''et al.'' |title=Deep vein thrombosis and pulmonary embolism in two cohorts: the longitudinal investigation of thromboembolism etiology |journal=Am. J. Med. |volume=117 |issue=1 |pages=19–25 |year=2004 |month=July |pmid=15210384 |doi=10.1016/j.amjmed.2004.01.018 |url=}}</ref><ref name="urlVenous Thromboembolism in Adult Hospitalizations — United States, 2007–2009">{{cite web |url=http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6122a1.htm?s_cid=mm6122a1_w |title=Venous Thromboembolism in Adult Hospitalizations — United States, 2007–2009 |format= |work= |accessdate=2012-10-06}}</ref> In addition, the risk for [[VTE]] was reported to consistently increase with age across both genders.<ref name="pmid15210384">{{cite journal |author=Cushman M, Tsai AW, White RH, ''et al.'' |title=Deep vein thrombosis and pulmonary embolism in two cohorts: the longitudinal investigation of thromboembolism etiology |journal=Am. J. Med. |volume=117 |issue=1 |pages=19–25 |year=2004 |month=July |pmid=15210384 |doi=10.1016/j.amjmed.2004.01.018 |url=}}</ref> | ||
===Race=== | ===Race=== | ||
* There is a significant difference in the incidence of VTE as it relates to race. African Americans characteristically have the highest incidence of VTE and Caucasians rank as the second highest incidence of VTE.<ref name="pmid12814979">{{cite journal| author=White RH| title=The epidemiology of venous thromboembolism. | journal=Circulation | year= 2003 | volume= 107 | issue= 23 Suppl 1 | pages= I4-8 | pmid=12814979 | doi=10.1161/01.CIR.0000078468.11849.66 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12814979 }} </ref> | * There is a significant difference in the incidence of [[VTE]] as it relates to race. African Americans characteristically have the highest incidence of [[VTE]] and Caucasians rank as the second highest incidence of [[VTE]].<ref name="pmid12814979">{{cite journal| author=White RH| title=The epidemiology of venous thromboembolism. | journal=Circulation | year= 2003 | volume= 107 | issue= 23 Suppl 1 | pages= I4-8 | pmid=12814979 | doi=10.1161/01.CIR.0000078468.11849.66 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12814979 }} </ref> | ||
* Lower thrombosis incidences in non-Caucasians may be related to a lower prevalence of disorders like [[Factor V Leiden]] or [[Thrombin#Prothrombin 20210a mutation|Prothrombin 20210A mutation]].<ref name="pmid9109469">{{cite journal| author=Ridker PM, Miletich JP, Hennekens CH, Buring JE| title=Ethnic distribution of factor V Leiden in 4047 men and women. Implications for venous thromboembolism screening. | journal=JAMA | year= 1997 | volume= 277 | issue= 16 | pages= 1305-7 | pmid=9109469 | doi= | pmc= | url= }} </ref><ref name="pmid9415695">{{cite journal| author=Gregg JP, Yamane AJ, Grody WW| title=Prevalence of the factor V-Leiden mutation in four distinct American ethnic populations. | journal=Am J Med Genet | year= 1997 | volume= 73 | issue= 3 | pages= 334-6 | pmid=9415695 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9415695 }} </ref> | * Lower thrombosis incidences in non-Caucasians may be related to a lower prevalence of disorders like [[Factor V Leiden]] or [[Thrombin#Prothrombin 20210a mutation|Prothrombin 20210A mutation]].<ref name="pmid9109469">{{cite journal| author=Ridker PM, Miletich JP, Hennekens CH, Buring JE| title=Ethnic distribution of factor V Leiden in 4047 men and women. Implications for venous thromboembolism screening. | journal=JAMA | year= 1997 | volume= 277 | issue= 16 | pages= 1305-7 | pmid=9109469 | doi= | pmc= | url= }} </ref><ref name="pmid9415695">{{cite journal| author=Gregg JP, Yamane AJ, Grody WW| title=Prevalence of the factor V-Leiden mutation in four distinct American ethnic populations. | journal=Am J Med Genet | year= 1997 | volume= 73 | issue= 3 | pages= 334-6 | pmid=9415695 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9415695 }} </ref> | ||
=== | ===Percent Distribution of VTE by Subtypes=== | ||
* | * As depicted by the figure below, the majority of [[VTE]] events is [[asymptomatic]]; while some cases present with [[fatal]] [[PE]]. | ||
[[File:Challenge of Assessing VTE.JPG|300x400px]] | |||
[[File: | |||
* The percentages of the different subtypes of PE are: | |||
* | ** Massive PE: 5-10% | ||
** Submassive PE: 20-25% | |||
* | ** Low-risk PE: ~70% | ||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
[[Category:Hematology]] | [[Category:Hematology]] | ||
[[Category:Pulmonology]] | [[Category:Pulmonology]] | ||
[[Category:Cardiology]] | [[Category:Cardiology]] | ||
[[Category:Emergency medicine]] | [[Category:Emergency medicine]] | ||
{{WH}} | {{WH}} | ||
{{WS}} | {{WS}} | ||
Latest revision as of 13:47, 11 October 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] The APEX Trial Investigators; Associate Editor(s)-in-Chief: Rim Halaby, M.D. [2]
Overview
The precise number of people affected by venous thromboembolism(VTE), that is either deep vein thrombosis, pulmonary embolism (PE), or both, is unknown, but estimates range from 300,000 to 600,000 (1 to 2 per 1,000, and in those over 80 years of age, as high as 1 in 100) each year in the United States. Approximately 5 to 8% of the U.S. population has one of several genetic risk factors, also known as inherited thrombophilias in which a genetic defect can be identified that increases the risk for thrombosis.[1][2]
Epidemiology and Demographics
Incidence
- The precise number of people affected by venous thromboembolism (VTE), that is either deep vein thrombosis (DVT), pulmonary embolism (PE), or both, is unknown, but estimates range from 300,000 to 600,000 (1 to 2 per 1,000, and in those over 80 years of age, as high as 1 in 100) each year in the United States.[1][2]
- In the United States, the annual incidence of VTE is estimated to be approximately 100 per 100,000 persons.[3]
Age
The incidence of VTE increases with age, ranging from < 5 cases per 100,000 people in childhood to 500 cases per 100,000 people in the elderly.[3] Subjects who are more than 65 years of age are at three times higher risk for VTE compared to those who are 45-54 years old.[4]
Gender
Studies about differences in the incidence of VTE by gender have mixed results.[5][6][4][7] In addition, the risk for VTE was reported to consistently increase with age across both genders.[4]
Race
- There is a significant difference in the incidence of VTE as it relates to race. African Americans characteristically have the highest incidence of VTE and Caucasians rank as the second highest incidence of VTE.[3]
- Lower thrombosis incidences in non-Caucasians may be related to a lower prevalence of disorders like Factor V Leiden or Prothrombin 20210A mutation.[8][9]
Percent Distribution of VTE by Subtypes
- As depicted by the figure below, the majority of VTE events is asymptomatic; while some cases present with fatal PE.
- The percentages of the different subtypes of PE are:
- Massive PE: 5-10%
- Submassive PE: 20-25%
- Low-risk PE: ~70%
References
- ↑ 1.0 1.1 CDC- Deep Vein Thrombosis (DVT) / Pulmonary Embolism (PE) — Blood Clot Forming in a Vein
- ↑ 2.0 2.1 Beckman MG, Hooper WC, Critchley SE, Ortel TL (2010). "Venous thromboembolism: a public health concern". Am J Prev Med. 38 (4 Suppl): S495–501. doi:10.1016/j.amepre.2009.12.017. PMID 20331949.
- ↑ 3.0 3.1 3.2 White RH (2003). "The epidemiology of venous thromboembolism". Circulation. 107 (23 Suppl 1): I4–8. doi:10.1161/01.CIR.0000078468.11849.66. PMID 12814979. Unknown parameter
|month=ignored (help) - ↑ 4.0 4.1 4.2 Cushman M, Tsai AW, White RH, Heckbert SR, Rosamond WD, Enright P; et al. (2004). "Deep vein thrombosis and pulmonary embolism in two cohorts: the longitudinal investigation of thromboembolism etiology". Am J Med. 117 (1): 19–25. doi:10.1016/j.amjmed.2004.01.018. PMID 15210384.
- ↑ Silverstein MD, Heit JA, Mohr DN, Petterson TM, O'Fallon WM, Melton LJ (1998). "Trends in the incidence of deep vein thrombosis and pulmonary embolism: a 25-year population-based study". Arch. Intern. Med. 158 (6): 585–93. PMID 9521222. Unknown parameter
|month=ignored (help) - ↑ Kniffin WD, Baron JA, Barrett J, Birkmeyer JD, Anderson FA (1994). "The epidemiology of diagnosed pulmonary embolism and deep venous thrombosis in the elderly". Arch. Intern. Med. 154 (8): 861–6. PMID 8154949. Unknown parameter
|month=ignored (help) - ↑ "Venous Thromboembolism in Adult Hospitalizations — United States, 2007–2009". Retrieved 2012-10-06.
- ↑ Ridker PM, Miletich JP, Hennekens CH, Buring JE (1997). "Ethnic distribution of factor V Leiden in 4047 men and women. Implications for venous thromboembolism screening". JAMA. 277 (16): 1305–7. PMID 9109469.
- ↑ Gregg JP, Yamane AJ, Grody WW (1997). "Prevalence of the factor V-Leiden mutation in four distinct American ethnic populations". Am J Med Genet. 73 (3): 334–6. PMID 9415695.