TRENDS IN THE INCIDENCE OF DEEP-VEIN THROMBOSIS AND PULMONARY-EMBOLISM - A 25-YEAR POPULATION-BASED STUDY

Background: The incidence of venous thromboembolism has not been well described, and there are no studies of long-term trends in the inciden ce of venous thromboembolism. Objectives: To estimate the incidence of deep vein thrombosis and pulmonary embolism and to describe trends in incidence. Methods: We performed a retrospective review of the comple te medical records from a population-based inception cohort of 2218 pa tients who resided within Olmsted Country, Minnesota, and had an incid ent deep vein thrombosis or pulmonary embolism during the 25-year peri od from 1966 through 1990. Results: The overall average age-and sex-ad justed annual incidence of venous thromboembolism was 117 per 100 000 (deep vein thrombosis, 48 per 100 000, pulmonary embolism, 69 per 100 000), with higher age-adjusted rates among males than females (130 vs 110 per 100 000, respectively). The incidence of venous thromboembolis m rose markedly with increasing age for both sexes, with pulmonary emb olism accounting for most of the increase. The incidence of pulmonary embolism was approximately 45% lower during the last 15 years of the s tudy for both sexes and all age strata, while the incidence of deep ve in thrombosis remained constant for males across all age strata, decre ased for females younger than 55 years, and increased for women older than 60 years. Conclusions: Venous thromboembolism is a major national health problem, especially among the elderly. While the incidence of pulmonary embolism has decreased over time, the incidence of deep vein thrombosis remains unchanged for men and is increasing for older wome n. These findings emphasize the need for more accurate identification of patients at risk for venous thromboembolism, as well as a safe and effective prophylaxis.