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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
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1991
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Hospital IncidenceHospital MedicineThrombosisVenous ThrombosisVenous Disease TreatmentHematologyClinical EpidemiologyVascular SurgeryPublic HealthWorcester Dvt StudyVenous DiseaseOutcomes ResearchMetropolitan WorcesterEpidemiologyPulmonary EmbolismCardiovascular DiseasePatient SafetyCoagulopathyMedicineCommunity-wide StudyEmergency Medicine
Because of its silent presentation and low autopsy rates, the true incidence, prevalence, and mortality of venous thromboembolism remain unclear. A community‑wide study was carried out in 16 short‑stay hospitals in Worcester, Massachusetts, to assess the incidence and case‑fatality rates of deep vein thrombosis and pulmonary embolism among patients hospitalized from July 1, 1985 to December 31, 1986. The study reported an average annual incidence of 48 per 100 000 for DVT alone and 23 per 100 000 for PE (with or without DVT), with rates increasing exponentially with age; in‑hospital case‑fatality was 12%, long‑term mortality after discharge was 19%, 25%, and 30% at 1, 2, and 3 years, respectively, suggesting roughly 170 000 new clinically recognized cases and 99 000 recurrent hospitalizations annually in U.S. short‑stay hospitals.
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. (<i>Arch Intern Med.</i>1991;151:933-938)