Md. Silverstein et al., TRENDS IN THE INCIDENCE OF DEEP-VEIN THROMBOSIS AND PULMONARY-EMBOLISM - A 25-YEAR POPULATION-BASED STUDY, Archives of internal medicine, 158(6), 1998, pp. 585-593
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.