Deep vein thrombosis epidemiology and demographics: Difference between revisions

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'''Editors-in-Chief:''' [[C. Michael Gibson, M.S., M.D.]] '''Associate Editor-In-Chief''': [[User:Ujjwal Rastogi|Ujjwal Rastogi, MBBS]] [mailto:urastogi@perfuse.org]
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| [[File:Siren.gif|30px|link=Deep vein thrombosis resident survival guide]]|| <br> || <br>
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'''Editor(s)-In-Chief:''' {{ATI}}, [[C. Michael Gibson, M.S., M.D.]] [mailto:charlesmichaelgibson@gmail.com]; '''Associate Editor(s)-In-Chief:''' {{CZ}}; [[User:Kashish Goel|Kashish Goel, M.D.]]; [[User:Justine Cadet|Justine Cadet]]; {{Rim}}
{{Deep vein thrombosis}}
{{Deep vein thrombosis}}


==Overview==
==Overview==
[[Deep Vein Thrombosis]] is highly prevalent in the general population of USA and accounts for approximately 150,000 deaths in a year. Its prevalence is estimated to be 100 cases/100,000 persons/year in US.
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.  Estimates suggest that 60,000-100,000 Americans die of VTE, 10 to 30% of which will die within one month of diagnosis.  Among people who have had a DVT, one-half will have long-term complications ([[post-thrombotic syndrome]]) such as swelling, pain, discoloration, and scaling in the affected limb.  One-third (about 33%) of people with VTE will have a recurrence within 10 years.  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>
 
Over 200,000 new cases of VTE occur annually. About two-thirds of episodes manifest as DVT and one-third as PE with or without DVT.
==Epidemiology and Demographics==
Of these, 30 percent die within 30 days, one-fifth suffer sudden death due to PE, and about 30 percent develop recurrent VTE within 10 years. Independent predictors for recurrence include increasing age, obesity, malignant neoplasm and extremity paresis.
===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 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>
 
===Age===
The incidence of VTE increases with age, ranging from less than 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===
Studies about differences in the incidence of VTE by gender have mixed results.  While some reported a higher incidence of DVT among young females,<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> others reported it among either older females,<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> or in men.<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 DVT 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===
* There is a significant difference in the incidence of DVT as it relates to race.  African Americans characteristically have the highest incidence of DVT while Caucasians rank as the second highest incidence of DVT.<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>
* When compared to African Americans and Caucasians, the incidence of DVT is noted to be two to four times lower in Hispanics and Asian-Pacific Islanders.<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>
*More than 25,000 people die in England from venous thromboembolism developed in hospital. This is more than the total number of deaths attributable to [[breast cancer]], [[AIDS]], and road traffic accidents, when combined together.
 
===Hospitalization for VTE===
* During 2007–2009, an estimated annual average of 547,596 hospitalizations had a diagnosis of VTE for adults aged ≥18 years. Estimates for DVT and PE diagnoses were not mutually exclusive. An estimated annual average of 348,558 adult hospitalizations had a diagnosis of DVT, and 277,549 adult hospitalizations had a diagnosis of PE. An estimated annual average of 78,511 adult hospitalizations (14% of overall VTE hospitalizations) had diagnoses of both DVT and PE.<ref name=CDC2> [http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6122a1.htm?s_cid=mm6122a1_w ] Hussain R. Yusuf, MD, James Tsai, MD, Hani K. Atrash, MD, Sheree Boulet, DrPH, Scott D. Grosse, PhD, Div of Blood Disorders, National Center on Birth Defects and Developmental Disabilities, CDC. Venous Thromboembolism in Adult Hospitalizations — United States, 2007–2009</ref>
 
* The estimated average annual number of hospitalizations with VTE was successively greater among older age groups: 54,034 for persons aged 18–39 years; 143,354 for persons aged 40–59 years; and 350,208 for persons aged ≥60 years. The estimated average annual number of hospitalizations with VTE was comparable for men (250,973) and women (296,623).<ref name=CDC2> [http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6122a1.htm?s_cid=mm6122a1_w ] Hussain R. Yusuf, MD, James Tsai, MD, Hani K. Atrash, MD, Sheree Boulet, DrPH, Scott D. Grosse, PhD, Div of Blood Disorders, National Center on Birth Defects and Developmental Disabilities, CDC. Venous Thromboembolism in Adult Hospitalizations — United States, 2007–2009</ref>  Shown below is an image depicting the estimated average annual number of hospitalization with a diagnosis of DVT, PE, or VTE by age and sex (image courtesy of CDC.gov<ref name=CDC2> [http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6122a1.htm?s_cid=mm6122a1_w ] Hussain R. Yusuf, MD, James Tsai, MD, Hani K. Atrash, MD, Sheree Boulet, DrPH, Scott D. Grosse, PhD, Div of Blood Disorders, National Center on Birth Defects and Developmental Disabilities, CDC. Venous Thromboembolism in Adult Hospitalizations — United States, 2007–2009</ref>).
 
[[File:Estimated average annual number of hospitalization VTE.gif]]
 
* The average annual rates of hospitalizations with a discharge diagnosis of DVT, PE, or VTE among adults were 152, 121, and 239 per 100,000 population, respectively. For VTE, the average annual rates were 60 per 100,000 population aged 18–39 years, 143 for persons aged 40–49 years, 200 for persons aged 50–59 years, 391 for persons aged 60–69 years, 727 for persons aged 70–79 years, and 1,134 for persons aged ≥80 years. The rates of hospitalization were similar for men and women, and the point estimates increased for both sexes by age.<ref name=CDC2> [http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6122a1.htm?s_cid=mm6122a1_w ] Hussain R. Yusuf, MD, James Tsai, MD, Hani K. Atrash, MD, Sheree Boulet, DrPH, Scott D. Grosse, PhD, Div of Blood Disorders, National Center on Birth Defects and Developmental Disabilities, CDC. Venous Thromboembolism in Adult Hospitalizations — United States, 2007–2009</ref>
 
* On average, 28,726 hospitalized adults with a VTE diagnosis died each year. Of these patients, an average of 13,164 had a DVT diagnosis and 19,297 had a PE diagnosis; 3,735 had both DVT and PE diagnoses.<ref name=CDC2> [http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6122a1.htm?s_cid=mm6122a1_w ] Hussain R. Yusuf, MD, James Tsai, MD, Hani K. Atrash, MD, Sheree Boulet, DrPH, Scott D. Grosse, PhD, Div of Blood Disorders, National Center on Birth Defects and Developmental Disabilities, CDC. Venous Thromboembolism in Adult Hospitalizations — United States, 2007–2009</ref>


==Prevalence by Age==
===Recurrence of VTE===
DVT is much more common in the elderly population as compared to pediatrics.  About 1 in 100,000 people under the age of 18 experiences deep vein thrombosis, possibly due to
* One-third (about 33%) of people with VTE will have a recurrence within 10 years.<ref name=CDC3>[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>
*Children heartrate being higher than adult
*Relatively active lifestyle when compared with adults
*Fewer comorbidities (e.g. malignancy).


Age greater than 45 is significantly associated with increased incidence of DVT.<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>
* The risk of recurrence of [[VTE]] in patients diagnosed with first-time [[VTE]] is estimated to be around 7-8 percent per year during an average follow up period of 2.2 years of subsequent observation of 265 patients.<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>


==Prevalence by Gender==
* Among patients with a first episode of VTE, the risk of recurrence of VTE is particularly elevated in the first 6 to 12 months following the first episode of VTE.  The risk of recurrent VTE remains up to 10 years, with a estimated cumulative incidence of first overall VTE recurrence of 30 %.  Predictors for recurrence of [[VTE]] include [[malignancy]], neurological diseases, and [[paresis]].<ref name="pmid10737275">{{cite journal |author=Heit JA, Mohr DN, Silverstein MD, Petterson TM, O'Fallon WM, Melton LJ |title=Predictors of recurrence after deep vein thrombosis and pulmonary embolism: a population-based cohort study |journal=Arch. Intern. Med. |volume=160 |issue=6 |pages=761–8 |year=2000 |month=March |pmid=10737275 |doi= |url=}}</ref>
Males gender is associated with a higher risk than female gender, and the risk increases with age in both genders.  


In studies conducted in Worcester, Massachusetts, and Olmsted County, Minnesota, the incidence of [[Venous thromboembolism]] (VTE) was about 1 in 1,000. In both studies, VTE was more common in men; for each 10-year increase in age, the incidence doubled. By extrapolation, it's estimated
* In recent years, the increase in [[thrombosis]] incidence may be related to improved diagnostic modalities and increased awareness by clinicians.<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>
that more than 250,000 patients are hospitalized annually with VTE.<ref name="pmid9654541">{{cite journal| author=Goldhaber SZ| title=Pulmonary embolism. | journal=N Engl J Med | year= 1998 | volume= 339 | issue= 2 | pages= 93-104 | pmid=9654541 | doi=10.1056/NEJM199807093390207 | pmc= | url= }} </ref>


==Prevalence by Race==
===Complications of VTE===
Caucasians and African Americans have a significantly higher incidence than Hispanics and Asians or Pacific Islanders.<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> Observed ethnic differences in thrombosis incidence might be related to a lower prevalence of disorders like factor V Leiden or the prothrombin 20210A mutation in non-Caucasians.<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>
* Estimates suggest that 60,000-100,000 Americans die of VTE, 10 to 30% of which will die within one month of diagnosis.<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><ref name=CDC3>[http://www.cdc.gov/ncbddd/dvt/data.html CDC- Deep Vein Thrombosis (DVT) / Pulmonary Embolism (PE) — Blood Clot Forming in a Vein]</ref>
 
* Among people who have had a DVT, one-half will have long-term complications ([[post-thrombotic syndrome]]) such as swelling, pain, discoloration, and scaling in the affected limb.<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><ref name=CDC3>[http://www.cdc.gov/ncbddd/dvt/data.html CDC- Deep Vein Thrombosis (DVT) / Pulmonary Embolism (PE) — Blood Clot Forming in a Vein]</ref>


==References==
==References==
{{reflist|2}}
{{reflist|2}}


 
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Latest revision as of 11:58, 13 July 2014
Resident
Survival
Guide

Editor(s)-In-Chief: The APEX Trial Investigators, C. Michael Gibson, M.S., M.D. [2]; Associate Editor(s)-In-Chief: Cafer Zorkun, M.D., Ph.D. [3]; Kashish Goel, M.D.; Justine Cadet; Rim Halaby, M.D. [4]

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Overview

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. Estimates suggest that 60,000-100,000 Americans die of VTE, 10 to 30% of which will die within one month of diagnosis. Among people who have had a DVT, one-half will have long-term complications (post-thrombotic syndrome) such as swelling, pain, discoloration, and scaling in the affected limb. One-third (about 33%) of people with VTE will have a recurrence within 10 years. 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]

Age

The incidence of VTE increases with age, ranging from less than 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. While some reported a higher incidence of DVT among young females,[5] others reported it among either older females,[6] or in men.[4][7] In addition, the risk for DVT was reported to consistently increase with age across both genders.[4]

Race

  • There is a significant difference in the incidence of DVT as it relates to race. African Americans characteristically have the highest incidence of DVT while Caucasians rank as the second highest incidence of DVT.[3]
  • When compared to African Americans and Caucasians, the incidence of DVT is noted to be two to four times lower in Hispanics and Asian-Pacific Islanders.[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]
  • More than 25,000 people die in England from venous thromboembolism developed in hospital. This is more than the total number of deaths attributable to breast cancer, AIDS, and road traffic accidents, when combined together.

Hospitalization for VTE

  • During 2007–2009, an estimated annual average of 547,596 hospitalizations had a diagnosis of VTE for adults aged ≥18 years. Estimates for DVT and PE diagnoses were not mutually exclusive. An estimated annual average of 348,558 adult hospitalizations had a diagnosis of DVT, and 277,549 adult hospitalizations had a diagnosis of PE. An estimated annual average of 78,511 adult hospitalizations (14% of overall VTE hospitalizations) had diagnoses of both DVT and PE.[10]
  • The estimated average annual number of hospitalizations with VTE was successively greater among older age groups: 54,034 for persons aged 18–39 years; 143,354 for persons aged 40–59 years; and 350,208 for persons aged ≥60 years. The estimated average annual number of hospitalizations with VTE was comparable for men (250,973) and women (296,623).[10] Shown below is an image depicting the estimated average annual number of hospitalization with a diagnosis of DVT, PE, or VTE by age and sex (image courtesy of CDC.gov[10]).

  • The average annual rates of hospitalizations with a discharge diagnosis of DVT, PE, or VTE among adults were 152, 121, and 239 per 100,000 population, respectively. For VTE, the average annual rates were 60 per 100,000 population aged 18–39 years, 143 for persons aged 40–49 years, 200 for persons aged 50–59 years, 391 for persons aged 60–69 years, 727 for persons aged 70–79 years, and 1,134 for persons aged ≥80 years. The rates of hospitalization were similar for men and women, and the point estimates increased for both sexes by age.[10]
  • On average, 28,726 hospitalized adults with a VTE diagnosis died each year. Of these patients, an average of 13,164 had a DVT diagnosis and 19,297 had a PE diagnosis; 3,735 had both DVT and PE diagnoses.[10]

Recurrence of VTE

  • One-third (about 33%) of people with VTE will have a recurrence within 10 years.[11][2]
  • The risk of recurrence of VTE in patients diagnosed with first-time VTE is estimated to be around 7-8 percent per year during an average follow up period of 2.2 years of subsequent observation of 265 patients.[4]
  • Among patients with a first episode of VTE, the risk of recurrence of VTE is particularly elevated in the first 6 to 12 months following the first episode of VTE. The risk of recurrent VTE remains up to 10 years, with a estimated cumulative incidence of first overall VTE recurrence of 30 %. Predictors for recurrence of VTE include malignancy, neurological diseases, and paresis.[12]
  • In recent years, the increase in thrombosis incidence may be related to improved diagnostic modalities and increased awareness by clinicians.[3]

Complications of VTE

  • Estimates suggest that 60,000-100,000 Americans die of VTE, 10 to 30% of which will die within one month of diagnosis.[2][11]
  • Among people who have had a DVT, one-half will have long-term complications (post-thrombotic syndrome) such as swelling, pain, discoloration, and scaling in the affected limb.[2][11]

References

  1. ↑ 1.0 1.1 CDC- Deep Vein Thrombosis (DVT) / Pulmonary Embolism (PE) — Blood Clot Forming in a Vein
  2. ↑ 2.0 2.1 2.2 2.3 2.4 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. ↑ 3.0 3.1 3.2 3.3 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. ↑ 4.0 4.1 4.2 4.3 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.
  5. ↑ 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)
  6. ↑ 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)
  7. ↑ "Venous Thromboembolism in Adult Hospitalizations — United States, 2007–2009". Retrieved 2012-10-06.
  8. ↑ 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.
  9. ↑ 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.
  10. ↑ 10.0 10.1 10.2 10.3 10.4 [1] Hussain R. Yusuf, MD, James Tsai, MD, Hani K. Atrash, MD, Sheree Boulet, DrPH, Scott D. Grosse, PhD, Div of Blood Disorders, National Center on Birth Defects and Developmental Disabilities, CDC. Venous Thromboembolism in Adult Hospitalizations — United States, 2007–2009
  11. ↑ 11.0 11.1 11.2 CDC- Deep Vein Thrombosis (DVT) / Pulmonary Embolism (PE) — Blood Clot Forming in a Vein
  12. ↑ Heit JA, Mohr DN, Silverstein MD, Petterson TM, O'Fallon WM, Melton LJ (2000). "Predictors of recurrence after deep vein thrombosis and pulmonary embolism: a population-based cohort study". Arch. Intern. Med. 160 (6): 761–8. PMID 10737275. Unknown parameter |month= ignored (help)

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