Heit John A, Crusan Daniel J, Ashrani Aneel A, Petterson Tanya M, Bailey Kent R
Department of Cardiovascular Diseases.
Division of Hematology, Department of Internal Medicine.
Blood. 2017 Jul 13;130(2):109-114. doi: 10.1182/blood-2016-12-758995. Epub 2017 May 8.
The annual number of US venous thromboembolism (VTE) events, the number of potentially preventable events, and the effect of hospitalization-based prophylaxis are uncertain. We estimated VTE attack (incident plus recurrent VTE) rates and the total annual number of US VTE events related and unrelated to hospitalization using Rochester Epidemiology Project resources to identify all Olmsted County, Minnesota, residents with incident or recurrent VTE over the 6-year period 2005-2010. The average annual VTE attack rates related and unrelated to hospitalization were 282 and 8 per 10 000 person-years, respectively. The estimated average number of US VTE events was 495 669 per year (48% unrelated to hospitalization). Among Olmsted County residents hospitalized at a Mayo Clinic hospital from 2005 to 2010, the proportion of patients receiving VTE prophylaxis or with an indication that prophylaxis was unnecessary increased from ∼40% in 2005 to ∼90% by 2010. The annual age- and sex-adjusted hospitalization-related (in-hospital) VTE attack rates from 2005 to 2010 ranged from 251 to 306 (1155 to 1751) per 10 000 person-years (bed-years) and did not change significantly. The median durations of hospitalization and in-hospital prophylaxis were 3 days and 70 hours, respectively. A total of 75% of VTE events occurred after hospital discharge, with a 19.5-day median time to VTE. Additional efforts are needed to identify the individual inpatient and outpatient at high risk for incident and recurrent VTE and target (longer duration) primary and secondary prophylaxis to high-risk individuals who would benefit most.
美国每年静脉血栓栓塞（VTE）事件的数量、潜在可预防事件的数量以及基于住院治疗的预防措施的效果尚不确定。我们利用罗切斯特流行病学项目的资源，估算了2005年至2010年这6年期间美国与住院相关和不相关的VTE发作（新发加复发VTE）率以及VTE事件的年度总数，以确定明尼苏达州奥尔姆斯特德县所有新发或复发VTE的居民。与住院相关和不相关的VTE年平均发作率分别为每10000人年282例和8例。美国VTE事件的估计年平均数量为每年495669例（48%与住院无关）。在2005年至2010年于梅奥诊所医院住院的奥尔姆斯特德县居民中，接受VTE预防或有证据表明无需预防的患者比例从2005年的约40%增至2010年的约90%。2005年至2010年年龄和性别调整后的年度住院相关（院内）VTE发作率为每10000人年（床年）251至306例（1155至1751例），且无显著变化。住院和院内预防的中位持续时间分别为3天和70小时。总共75%的VTE事件发生在出院后，VTE的中位时间为19.5天。需要做出更多努力来识别发生新发和复发VTE的高危住院患者和门诊患者，并针对最能从中受益的高危个体进行（更长疗程的）一级和二级预防。
