Declining Long-term Risk of Adverse Events after First-time Community-presenting Venous Thromboembolism: The Population-based Worcester VTE Study (1999 to 2009)
Clinical & Population Health Research
Center for Outcomes Research; Department of Quantitative Health Sciences; Department of Medicine, Division of Cardiovascular Medicine
Cardiology | Cardiovascular Diseases | Clinical Epidemiology | Epidemiology
INTRODUCTION: Contemporary trends in health-care delivery are shifting the management of venous thromboembolism (VTE) events (deep vein thrombosis [DVT] and/or pulmonary embolism [PE]) from the hospital to the community, which may have implications for its prevention, treatment, and outcomes.
MATERIALS AND METHODS: Population-based surveillance study monitoring trends in clinical epidemiology among residents of the Worcester, Massachusetts, metropolitan statistical area (WMSA) diagnosed with an acute VTE in all 12 WMSA hospitals. Patients were followed for up to 3years after their index event. Total of 2334 WMSA residents diagnosed with first-time community-presenting VTE (occurring in an ambulatory setting or diagnosed within 24hours of hospitalization) from 1999 through 2009.
RESULTS: While PE patients were consistently admitted to the hospital for treatment over time, the proportion diagnosed with DVT-alone admitted to the hospital decreased from 67% in 1999 to 37% in 2009 (p value for trend
CONCLUSIONS: A decade of change in VTE management was accompanied by improved long-term outcomes. However, rates of adverse events remained fairly high in our population-based surveillance study, implying that new risk-assessment tools to identify individuals at increased risk for developing major adverse outcomes over the long term are needed.
DOI of Published Version
Huang W, Goldberg RJ, Cohen AT, Anderson FA, Kiefe CI, Gore JM, Spencer FA. Declining Long-term Risk of Adverse Events after First-time Community-presenting Venous Thromboembolism: The Population-based Worcester VTE Study (1999 to 2009). Thromb Res. 2015 Apr 11. pii: S0049-3848(15)00162-0. doi: 10.1016/j.thromres.2015.04.007. [Epub ahead of print] PubMed PMID: 25921936; PubMed Central PMCID: PMC4416217.
Huang, Wei; Goldberg, Robert J.; Cohen, A. T.; Anderson, Frederick A. Jr.; Kiefe, Catarina I.; Gore, Joel M.; and Spencer, Frederick A., "Declining Long-term Risk of Adverse Events after First-time Community-presenting Venous Thromboembolism: The Population-based Worcester VTE Study (1999 to 2009)" (2015). GSBS Student Publications. 1870.