A changing landscape: Temporal trends in incidence and characteristics of patients hospitalized with venous thromboembolism 2006-2015.


Journal

Thrombosis research
ISSN: 1879-2472
Titre abrégé: Thromb Res
Pays: United States
ID NLM: 0326377

Informations de publication

Date de publication:
Apr 2019
Historique:
received: 09 11 2018
revised: 31 01 2019
accepted: 09 02 2019
pubmed: 19 2 2019
medline: 18 12 2019
entrez: 19 2 2019
Statut: ppublish

Résumé

Venous thromboembolism (VTE) has major clinical and public health impact. However, only sparse data on calendar time trends in incidence from unselected populations reflecting current clinical practice are available. To examine temporal trends in the incidence and characteristics of patients hospitalized with first-time VTE in Denmark between 2006 and 2015. Using nationwide health care registries, we calculated yearly hospitalization rates for first-time VTE from 2006 to 2015. The rates were standardized to the age and sex distribution in 2006. Based on the hospitalization and prescription history of each patient, we assessed the risk profile and evaluated changes over time. We identified 67,426 patients with a first-time VTE hospitalization. The age- and sex-standardized incidence rate increased from 12.6 (95% CI: 12.3-12.9) per 10,000 person years at risk in 2006 to 15.1 (95% CI: 14.7-15.4) in 2015, corresponding to an increase of 19.8%. The increase was due to a 73.9% increase in the standardized incidence rate of pulmonary embolism (PE), whereas no increase was observed for deep vein thrombosis. The risk profile changed with an increasing proportion of elderly patients and patients with comorbidity (proportion of patients with a Charlson's Comorbidity Index score of ≥1). The hospitalization rate of first-time VTE, and particularly PE, has increased substantially within the last decade in Denmark. In addition, the risk profile of the VTE population has changed with more elderly and more patients with comorbidity being diagnosed. Further efforts are warranted to explore the changes in VTE epidemiology and the clinical implications.

Sections du résumé

BACKGROUND BACKGROUND
Venous thromboembolism (VTE) has major clinical and public health impact. However, only sparse data on calendar time trends in incidence from unselected populations reflecting current clinical practice are available.
OBJECTIVES OBJECTIVE
To examine temporal trends in the incidence and characteristics of patients hospitalized with first-time VTE in Denmark between 2006 and 2015.
PATIENTS/METHODS METHODS
Using nationwide health care registries, we calculated yearly hospitalization rates for first-time VTE from 2006 to 2015. The rates were standardized to the age and sex distribution in 2006. Based on the hospitalization and prescription history of each patient, we assessed the risk profile and evaluated changes over time.
RESULTS RESULTS
We identified 67,426 patients with a first-time VTE hospitalization. The age- and sex-standardized incidence rate increased from 12.6 (95% CI: 12.3-12.9) per 10,000 person years at risk in 2006 to 15.1 (95% CI: 14.7-15.4) in 2015, corresponding to an increase of 19.8%. The increase was due to a 73.9% increase in the standardized incidence rate of pulmonary embolism (PE), whereas no increase was observed for deep vein thrombosis. The risk profile changed with an increasing proportion of elderly patients and patients with comorbidity (proportion of patients with a Charlson's Comorbidity Index score of ≥1).
CONCLUSIONS CONCLUSIONS
The hospitalization rate of first-time VTE, and particularly PE, has increased substantially within the last decade in Denmark. In addition, the risk profile of the VTE population has changed with more elderly and more patients with comorbidity being diagnosed. Further efforts are warranted to explore the changes in VTE epidemiology and the clinical implications.

Identifiants

pubmed: 30776687
pii: S0049-3848(19)30040-4
doi: 10.1016/j.thromres.2019.02.009
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

46-53

Informations de copyright

Copyright © 2019 Elsevier Ltd. All rights reserved.

Auteurs

A M Münster (AM)

Unit for Thrombosis Research, Esbjerg, Hospital of South West Jutland, Denmark.

T B Rasmussen (TB)

Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark.

A M Falstie-Jensen (AM)

Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark.

L Harboe (L)

Bristol-Myers Squibb, Copenhagen, Denmark.

G Stynes (G)

Bristol-Myers Squibb, London, United Kingdom.

L Dybro (L)

Pfizer, Copenhagen, Denmark.

M L Hansen (ML)

Department of Cardiology, Gentofte Hospital, Copenhagen, Denmark.

A Brandes (A)

Department of Cardiology, Odense University Hospital, Odense, Denmark; Department of Clinical Research, the Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark.

E L Grove (EL)

Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark; Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark.

S P Johnsen (SP)

Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark; Danish Center for Clinical Health Services Research, Department of Clinical Medicine, Aalborg University and Aalborg University Hospital, Denmark. Electronic address: soeren.johnsen@rn.dk.

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Classifications MeSH