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Deep vein thrombosis and pulmonary embolism in two cohorts: the longitudinal investigation of thromboembolism etiology.
Am J Med 2004; 117(1):19-25AJ

Abstract

PURPOSE

To determine the incidence of deep vein thrombosis and pulmonary embolism in two cohorts representing regions of the United States.

METHODS

The sample comprised 21,680 participants of the Atherosclerosis Risk in Communities study and the Cardiovascular Health Study. Subjects were aged >/=45 years, resided in six communities, and were followed for 7.6 years. All hospitalizations were identified and thromboses were validated by chart review.

RESULTS

The age-standardized incidence of first-time venous thromboembolism was 1.92 per 1000 person-years. Rates were higher in men than women, and increased with age in both sexes. There was no antecedent trauma, surgery, immobilization, or diagnosis of cancer for 48% (175/366) of events. The 28-day case-fatality rate was 11% (29/265) after a first venous thromboembolism and 25% (17/67) for cancer-associated thrombosis. The recurrence rate 2 years after a first venous thromboembolism was 7.7% per year (95% confidence interval [CI]: 4.5% to 10.9% per year). Cancer was the only factor independently associated with 28-day fatality (relative risk [RR] = 5.2; 95% CI: 1.4 to 19.9) or recurrent thrombosis (RR = 9.2; 95% CI: 2.0 to 41.7).

CONCLUSION

The incidence of venous thromboembolism in this cohort of middle- and older-aged subjects was similar to that observed in more geographically homogeneous samples. Half of cases were idiopathic. Short-term mortality and 2-year recurrence rates were appreciable, especially among subjects with cancer. Based on this study we estimate that 187,000 cases of first-time venous thromboembolism are diagnosed yearly in the United States among those aged 45 years or older.

Authors+Show Affiliations

Department of Medicine, University of Vermont, Burlington, USA. mary.cushman@uvm.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

15210384

Citation

Cushman, Mary, et al. "Deep Vein Thrombosis and Pulmonary Embolism in Two Cohorts: the Longitudinal Investigation of Thromboembolism Etiology." The American Journal of Medicine, vol. 117, no. 1, 2004, pp. 19-25.
Cushman M, Tsai AW, White RH, et al. Deep vein thrombosis and pulmonary embolism in two cohorts: the longitudinal investigation of thromboembolism etiology. Am J Med. 2004;117(1):19-25.
Cushman, M., Tsai, A. W., White, R. H., Heckbert, S. R., Rosamond, W. D., Enright, P., & Folsom, A. R. (2004). Deep vein thrombosis and pulmonary embolism in two cohorts: the longitudinal investigation of thromboembolism etiology. The American Journal of Medicine, 117(1), pp. 19-25.
Cushman M, et al. Deep Vein Thrombosis and Pulmonary Embolism in Two Cohorts: the Longitudinal Investigation of Thromboembolism Etiology. Am J Med. 2004 Jul 1;117(1):19-25. PubMed PMID: 15210384.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Deep vein thrombosis and pulmonary embolism in two cohorts: the longitudinal investigation of thromboembolism etiology. AU - Cushman,Mary, AU - Tsai,Albert W, AU - White,Richard H, AU - Heckbert,Susan R, AU - Rosamond,Wayne D, AU - Enright,Paul, AU - Folsom,Aaron R, PY - 2002/11/07/received PY - 2004/01/31/revised PY - 2004/01/31/accepted PY - 2004/6/24/pubmed PY - 2004/7/21/medline PY - 2004/6/24/entrez SP - 19 EP - 25 JF - The American journal of medicine JO - Am. J. Med. VL - 117 IS - 1 N2 - PURPOSE: To determine the incidence of deep vein thrombosis and pulmonary embolism in two cohorts representing regions of the United States. METHODS: The sample comprised 21,680 participants of the Atherosclerosis Risk in Communities study and the Cardiovascular Health Study. Subjects were aged >/=45 years, resided in six communities, and were followed for 7.6 years. All hospitalizations were identified and thromboses were validated by chart review. RESULTS: The age-standardized incidence of first-time venous thromboembolism was 1.92 per 1000 person-years. Rates were higher in men than women, and increased with age in both sexes. There was no antecedent trauma, surgery, immobilization, or diagnosis of cancer for 48% (175/366) of events. The 28-day case-fatality rate was 11% (29/265) after a first venous thromboembolism and 25% (17/67) for cancer-associated thrombosis. The recurrence rate 2 years after a first venous thromboembolism was 7.7% per year (95% confidence interval [CI]: 4.5% to 10.9% per year). Cancer was the only factor independently associated with 28-day fatality (relative risk [RR] = 5.2; 95% CI: 1.4 to 19.9) or recurrent thrombosis (RR = 9.2; 95% CI: 2.0 to 41.7). CONCLUSION: The incidence of venous thromboembolism in this cohort of middle- and older-aged subjects was similar to that observed in more geographically homogeneous samples. Half of cases were idiopathic. Short-term mortality and 2-year recurrence rates were appreciable, especially among subjects with cancer. Based on this study we estimate that 187,000 cases of first-time venous thromboembolism are diagnosed yearly in the United States among those aged 45 years or older. SN - 0002-9343 UR - https://www.unboundmedicine.com/medline/citation/15210384/Deep_vein_thrombosis_and_pulmonary_embolism_in_two_cohorts:_the_longitudinal_investigation_of_thromboembolism_etiology_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002934304001676 DB - PRIME DP - Unbound Medicine ER -