College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73190, USA.
Am J Prev Med. 2010 Apr;38(4 Suppl):S502-9. doi: 10.1016/j.amepre.2010.01.010.
Deep vein thrombosis (DVT) and pulmonary embolism (PE), known collectively as venous thromboembolism (VTE), affect an estimated 900,000 people in the U.S. each year, resulting in several hundred thousand hospitalizations and about 300,000 deaths. Despite this substantial public health burden, no systematic collection of VTE-related morbidity and mortality data exists in the U.S. The available information about disease prevalence and incidence consists of estimates based mainly on population-based epidemiologic studies and analysis of hospital discharge or health insurance claims databases. The limited scope of the available data has raised the question of whether a systematic surveillance system for VTE should be established. To help answer this question and to make recommendations for the next steps toward better surveillance of VTE, the CDC asked the American Society of Hematology (ASH) to convene a national workshop of stakeholders representing relevant federal agencies, experts in VTE epidemiology and treatment, public health experts in VTE, and patient representatives. These groups were assembled by ASH for a 1-day meeting in Washington DC. The subspecialty experts included representatives from internal medicine, cardiovascular diseases, adult and pediatric hematology, surgery, obstetrics and gynecology, radiology, emergency medicine and trauma care, hospital practice and critical care, and geriatrics. Experts in epidemiology, healthcare quality, and health policy also participated. During the workshop, experts discussed their perspectives on the burden of disease from VTE and its diagnosis, treatment, and prevention. The workshop also focused on the advisability and feasibility of establishing systematic surveillance for VTE and included preliminary discussion of the advantages and disadvantages of various approaches. The workshop concluded that (1) improved utilization in clinical practice of existing, proven-effective preventive measures is critical to reducing the disease burden from VTE; (2) systematic surveillance of DVT and PE is needed to provide nationally representative data on the prevalence and annual incidence of DVT and PE in the U.S.; (3) tracking and documenting changes in the incidence of DVT and PE through systematic surveillance will be important to enhance prevention efforts; and (4) the CDC should convene a second group of experts to advise the agency in detail on the strengths, weaknesses, and feasibility of possible approaches to systematic surveillance for DVT and PE.
深静脉血栓形成（DVT）和肺栓塞（PE），统称为静脉血栓栓塞症（VTE），据估计每年在美国影响约 90 万人，导致数十万人住院，约 30 万人死亡。尽管存在如此巨大的公共卫生负担，但美国没有系统收集与 VTE 相关的发病率和死亡率数据。有关疾病流行率和发病率的可用信息主要基于基于人群的流行病学研究和对医院出院或医疗保险索赔数据库的分析。现有数据的范围有限，这引发了是否应建立 VTE 系统监测系统的问题。为了帮助回答这个问题，并就 VTE 更好的监测提出下一步建议，CDC 请美国血液学会（ASH）召集一个代表相关联邦机构、VTE 流行病学和治疗专家、VTE 公共卫生专家和患者代表的利益相关者国家研讨会。ASH 召集了这些团体，在华盛顿特区举行了为期一天的会议。该专业专家包括内科、心血管疾病、成人和儿科血液学、外科、妇产科、放射学、急诊和创伤护理、医院实践和重症监护以及老年医学等领域的代表。流行病学、医疗质量和卫生政策方面的专家也参加了会议。在研讨会上，专家们讨论了他们对 VTE 疾病负担及其诊断、治疗和预防的看法。研讨会还重点讨论了建立 VTE 系统监测的适宜性和可行性，包括初步讨论了各种方法的优缺点。研讨会得出以下结论：（1）改善现有、经过验证的预防措施在临床实践中的应用对降低 VTE 疾病负担至关重要；（2）需要对 DVT 和 PE 进行系统监测，以提供美国 DVT 和 PE 的患病率和年发病率的全国代表性数据；（3）通过系统监测跟踪和记录 DVT 和 PE 发病率的变化对于加强预防工作非常重要；（4）CDC 应召集第二组专家，详细向该机构提供关于 DVT 和 PE 系统监测可能方法的优势、劣势和可行性的建议。
