Hwang Hun-Gyu, Lee Ju Hyun, Kim Sang-A, Kim Yang-Ki, Yhim Ho-Young, Hong Junshik, Bang Soo-Mee
Respiratory Division, Department of Internal Medicine, Soonchunhyang University, School of Medicine, Gumi Hospital, Korea.
Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
J Korean Med Sci. 2022 May 2;37(17):e130. doi: 10.3346/jkms.2022.37.e130.
The incidence of venous thromboembolism (VTE) has gradually increased in the Korean population. This study aimed to evaluate the annual age- and sex-adjusted incidence rates (ASR) of VTE and anticoagulation trends between 2014 and 2018.
Using the Korean Health Insurance Review and Assessment Service database, we retrospectively identified VTE patients between 2014 and 2018 using both diagnostic and medication anticoagulant codes assigned within 6 months of the initial index event. Anticoagulant patterns were classified as follows: direct oral anticoagulants (DOAC), parenteral anticoagulants, warfarin, and mixed anticoagulation regimens.
We identified 95,205 patients with VTE (female, 56.8%). The ASR for VTE per 100,000 person-years increased from 32.8 in 2014 to 53.7 cases in 2018 (relative risk of 1.63; 95% confidence interval, 1.6-1.67). The VTE incidence rates were 25 times higher in the ≥ 80 group than in the 30s group. VTE occurred 1.29 times more often in women than in men. The proportion of DOAC prescriptions increased from 40.5% to 72.8%, whereas warfarin prescriptions decreased from 27% to 5.6% in 2014 and 2018.
In Korea, the ASRs of VTE continued to increase since 2014, but the rate of increase slowed in 2018. The VTE occurred more often in the elderly and in women. Five years after the introduction of DOACs in 2013, they accounted for 73% of all anticoagulants used to treat VTE.
韩国人群中静脉血栓栓塞症（VTE）的发病率逐渐上升。本研究旨在评估2014年至2018年间VTE的年龄和性别调整后的年发病率（ASR）以及抗凝治疗趋势。
利用韩国健康保险审查与评估服务数据库，我们通过在初始索引事件的6个月内分配的诊断和药物抗凝代码，回顾性地确定了2014年至2018年间的VTE患者。抗凝模式分类如下：直接口服抗凝剂（DOAC）、胃肠外抗凝剂、华法林和混合抗凝方案。
我们确定了95,205例VTE患者（女性占56.8%）。每10万人年的VTE ASR从2014年的32.8例增加到2018年的53.7例（相对风险为1.63；95%置信区间为1.6 - 1.67）。≥80岁组的VTE发病率比30多岁组高25倍。女性发生VTE的频率比男性高1.29倍。2014年至2018年，DOAC处方的比例从40.5%增加到72.8%，而华法林处方从27%下降到5.6%。
在韩国，自2014年以来VTE的ASR持续上升，但在2018年上升速度放缓。VTE在老年人和女性中更常见。2013年引入DOACs五年后，它们占用于治疗VTE的所有抗凝剂的73%。
