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Article
Incidence rates, clinical profile, and outcomes of patients with venous thromboembolism. The Worcester VTE study
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  • Frederick A. Spencer, McMaster University
  • Cathy Emery, University of Massachusetts Medical School
  • Samuel W. Joffe, University of Massachusetts Medical School
  • Luigi Pacifico, Fallon Community Health Care
  • Darleen M. Lessard, University of Massachusetts Medical School
  • George W. Reed, University of Massachusetts Medical School
  • Joel M. Gore, University of Massachusetts Medical School
  • Robert J. Goldberg, University of Massachusetts Medical School
UMMS Affiliation
Department of Medicine, Division of Cardiovascular Medicine; Department of Medicine, Division of Preventive and Behavorial Medicine
Date
7-25-2009
Document Type
Article
Abstract
While there have been advances in prophylaxis and management of venous thromboembolism (VTE), there are a dearth of data from the perspective of a community-wide study, on the epidemiology, management, and outcomes of patients with a first episode of deep vein thrombosis (DVT) or pulmonary embolism (PE). The purpose of this population-based observational study was to describe trends in the incidence rates, clinical profile, management, and outcomes for patients with VTE. The medical records of Worcester (MA) metropolitan area residents with ICD-9 codes consistent with possible VTE during 1999, 2001, and 2003 were independently validated and reviewed by trained abstractors. A total of 1,567 persons with first-time VTE were identified. Incidence rates (per 100,000) of VTE were stable between 1999 (109) and 2003 (117). A considerable proportion of patients treated for VTE had events of unclear clinical significance (e.g., isolated calf DVT, unconfirmed "possible" PE). By 2003, low-molecular-weight heparin was increasingly utilized as acute therapy and more than 25% of patients with VTE were managed as outpatients. Cumulative rates of recurrent VTE and major bleeding following initial VTE were high (approximately 16% and 12%, respectively, mean follow-up 1,216 days) and did not change significantly between 1999 and 2003. Our data suggest that while the incidence rates of VTE remain high, and outcomes suboptimal, there have been marked changes in its management. Whether these changes will result in future declines in VTE incidence and/or improved outcomes in the community setting will require further surveillance.
Rights and Permissions
Citation: J Thromb Thrombolysis. 2009 Nov;28(4):401-9. Link to article on publisher's site
Related Resources
Link to Article in PubMed
PubMed ID
19629642
Citation Information
Frederick A. Spencer, Cathy Emery, Samuel W. Joffe, Luigi Pacifico, et al.. "Incidence rates, clinical profile, and outcomes of patients with venous thromboembolism. The Worcester VTE study" Vol. 28 Iss. 4 (2009) ISSN: 1573-742X (Linking)
Available at: http://works.bepress.com/robert_goldberg/47/