Geersing Geert-Jan, Cazemier Selma, Rutten Frans, Fitzmaurice David A, Hoes Arno W
Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
Warwick Clinical Trials Unit, University of Warwick, Coventry, UK.
BMJ Open. 2018 Apr 20;8(4):e019967. doi: 10.1136/bmjopen-2017-019967.
Recent studies in referred populations of patients with superficial venous thrombosis (SVT) report risks of venous thromboembolic (VTE) sequelae (deep vein thrombosis or pulmonary embolism) as high as 25%. Likely, these estimates are lower in non-referred patients, but large-scale population-based studies are lacking. We aimed to estimate the incidence rate of SVT in primary care and quantify its risk of VTE sequelae.
A retrospective cohort study, using International Classification of Primary Care coding (K94.02) combined with free text searching (synonyms for SVT) to capture all SVT events. All patients were followed up for 3 months using manual free text searching.
Primary care.
All patients enlisted with general practitioners within the Utrecht General Practitioner Network between 2010 and 2016 (1 534 845 person-years follow-up).
The incidence rate of SVT was expressed as the number of SVT events per 1000 person-years of follow-up and the 3-month cumulative incidence of VTE events was calculated. Logistic regression analysis was used to compare patients with SVT with and without VTE sequelae.
A total of 2008 SVT cases were identified, that is, an SVT incidence rate of 1.31 (95% CI 1.25 to 1.37) per 1000 person-years follow-up, with higher rates notably with increasing age. VTE sequelae occurred in 83 patients; 51 at the time of SVT diagnosis and 32 patients during follow-up (total cumulative incidence of 4.1%; 95% CI 3.3% to 5.1%), and were more frequent in those with an active malignancy (OR 2.19; 95% 0.97 to 4.95) and less frequent in those with varicose veins at baseline (OR 0.57, 95% CI 0.34 to 0.94).
We found an incidence rate of SVT in primary care of 1.31 per 1000 person-years. The risks of VTE sequelae was relatively low at 4.1%, with the highest risk in patients with cancer and in those who experience an SVT in the absence of varicose veins.
近期针对转诊的浅静脉血栓形成（SVT）患者群体的研究报告称，静脉血栓栓塞（VTE）后遗症（深静脉血栓形成或肺栓塞）的风险高达25%。在未转诊的患者中，这些估计值可能较低，但缺乏大规模的基于人群的研究。我们旨在估计初级保健中SVT的发病率，并量化其VTE后遗症的风险。
一项回顾性队列研究，使用初级保健国际分类编码（K94.02）并结合自由文本搜索（SVT的同义词）来捕获所有SVT事件。所有患者通过人工自由文本搜索进行3个月的随访。
初级保健机构。
2010年至2016年期间乌得勒支全科医生网络内所有登记在全科医生处的患者（随访1534845人年）。
SVT的发病率以每1000人年随访中的SVT事件数表示，并计算VTE事件的3个月累积发病率。采用逻辑回归分析比较有和没有VTE后遗症的SVT患者。
共识别出2008例SVT病例，即每1000人年随访的SVT发病率为1.31（95%CI 1.25至1.37），发病率随年龄增长而显著升高。83例患者出现VTE后遗症；51例在SVT诊断时出现，32例在随访期间出现（总累积发病率为4.1%；95%CI 3.3%至5.1%），在患有活动性恶性肿瘤的患者中更常见（OR 2.19；95% 0.97至4.95），而在基线时有静脉曲张的患者中较少见（OR 0.57，95%CI 0..34至0.94）。
我们发现初级保健中SVT的发病率为每1000人年1.31例。VTE后遗症的风险相对较低，为4.1%，在癌症患者和无静脉曲张而发生SVT的患者中风险最高。
