Saber Ibrahim, Adamski Alys, Kuchibhatla Maragatha, Abe Karon, Beckman Michele, Reyes Nimia, Schulteis Ryan, Pendurthi Singh Bhavana, Sitlinger Andrea, Thames Elizabeth H, Ortel Thomas L
Division of Hematology, Department of Medicine Duke University Medical Center Durham North Carolina USA.
Centers for Disease Control and Prevention Atlanta Georgia USA.
Res Pract Thromb Haemost. 2022 Jul 21;6(5):e12769. doi: 10.1002/rth2.12769. eCollection 2022 Jul.
Venous thromboembolism (VTE) affects approximately 1-2 individuals per 1000 annually and is associated with an increased risk for pulmonary hypertension, postthrombotic syndrome, and recurrent VTE.
To determine risk factors, incidence, treatments, and outcomes of VTE through a 2-year surveillance program initiated in Durham County, North Carolina (population approximately 280,000 at time of study).
PATIENTS/METHODS: We performed a retrospective analysis of data actively collected from three hospitals in Durham County during the surveillance period.
A total of 987 patients were diagnosed with VTE, for an annual rate of 1.76 per 1000 individuals. Hospital-associated VTE occurred in 167 hospitalized patients (16.9%) and 271 outpatients who were hospitalized within 90 days of diagnosis (27.5%). Annual incidence was 1.98 per 1000 Black individuals compared to 1.25 per 1000 White individuals ( < 0.0001), and Black individuals with VTE were younger than White individuals ( < 0.0001). Common risk factors included active cancer, prolonged immobility, and obesity, and approximately half were still taking anticoagulant therapy 1 year later. A total of 224 patients died by 1 year (28.5% of patients for whom outcomes could be confirmed), and Black patients were more likely to have recurrent VTE than White patients during the first 6 months following initial presentation (9.4% vs. 4.1%, = 0.01).
Ongoing surveillance provides an effective strategy to identify patients with VTE and monitor treatment and outcomes. We demonstrated that hospital-associated VTE continues to be a major contributor to the burden of VTE and confirmed the higher incidence of VTE in Black compared to White individuals.
静脉血栓栓塞症（VTE）每年影响约千分之一至千分之二的人，并与肺动脉高压、血栓后综合征及复发性VTE风险增加相关。
通过在北卡罗来纳州达勒姆县启动的一项为期两年的监测项目（研究时人口约28万），确定VTE的危险因素、发病率、治疗方法及转归。
患者/方法：我们对监测期间从达勒姆县三家医院主动收集的数据进行了回顾性分析。
共987例患者被诊断为VTE，年发病率为千分之1.76。医院相关VTE发生在167例住院患者中（16.9%）以及271例在诊断后90天内住院的门诊患者中（27.5%）。黑人的年发病率为千分之1.98，而白人的年发病率为千分之1.25（<0.0001），且患VTE的黑人比白人年轻（<0.0001）。常见危险因素包括活动性癌症、长期制动和肥胖，约一半患者在1年后仍接受抗凝治疗。共有224例患者在1年内死亡（可确认转归患者中的28.5%），且在初次就诊后的前6个月内，黑人患者比白人患者更易发生复发性VTE（9.4%对4.1%，P = 0.01）。
持续监测为识别VTE患者及监测治疗和转归提供了一种有效策略。我们证明医院相关VTE仍是VTE负担的主要因素，并证实黑人VTE发病率高于白人。
