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Venous thromboembolism hospitalizations among American Indians and Alaska Natives
W Craig Hooper1, Robert C Holman, John A Heit
1Hematologic Disease Branch, Division of AIDS, STD, and TB Laboratory Research, National Center for Infectious Diseases, Centers for Disease Control and Prevention, US Department of Health and Human Services, Atlanta, GA 30333, USA. chooper@cdc.gov
Insights
Venous thromboembolism (VTE) hospitalization rates in American Indian/Alaska Native (AI/AN) populations decreased from 1980-1996. Rates were higher for females and varied by region, but overall AI/AN VTE rates appear lower than Caucasian rates.
Area of Science:
- Public Health
- Epidemiology
- Cardiovascular Health
Background:
- Cardiovascular disease (CVD) is increasing in American Indian/Alaska Native (AI/AN) populations.
- Venous thromboembolism (VTE) is a significant component of cardiovascular morbidity.
Purpose of the Study:
- To describe VTE-associated hospitalizations among AI/AN patients.
- To analyze trends and demographic variations in VTE hospitalizations within the AI/AN population from 1980-1996.
Main Methods:
- Utilized the Indian Health Service (IHS) hospital discharge database.
- Analyzed hospitalization rates, age at hospitalization, sex-specific rates, and regional variations.
- Calculated rates per 100,000 population over the 17-year study period.
Main Results:
- The average overall VTE hospitalization rate in AI/ANs was 33.1 per 100,000, showing a decrease from 38.4 (1980-1982) to 33.2 (1994-1996).
- Female VTE hospitalization rates significantly decreased (46.1 to 36.7 per 100,000), while male rates remained unchanged.
- VTE hospitalization rates were highest in the East (52.2) and lowest in Alaska (16.1 per 100,000).
Conclusions:
- Overall VTE hospitalization rates in AI/AN populations have decreased and appear lower than in Caucasian populations.
- Significant decrease in VTE hospitalizations observed in females, suggesting potential shifts in risk factors or healthcare access.
- Regional disparities in VTE hospitalization rates highlight the need for geographically targeted public health interventions.
Abstract:
Cardiovascular disease (CVD) has been reported to be on the increase in the American Indian/Alaska Native (AI/AN) population. The Indian Health Service (IHS) hospital discharge database was used to describe venous thromboembolism (VTE)-associated hospitalizations among patients receiving IHS-reported medical care in the United States from 1980 through 1996. The average overall VTE-associated hospitalization rate in the AI/AN population during 1980-1996 was 33.1 per 100,000, however, the rate significantly decreased from 38.4 per 100,000 AI/ANs in 1980-1982 to 33.2 in 1994-1996. The average age at hospitalization was 50.4 years, which was consistent during the 17-year period. The overall annual VTE hospitalization rate was higher for females than for males (38.0 versus 27.7 per 100,000). The female VTE hospitalization rates decreased significantly from 46.1 per 100,000 in 1980-1982 to 36.7 per 100,000 in 1994-1996 (risk ratio: RR=1.3; 95% confidence interval: CI=1.1-1.4), while the rates for males remained unchanged. The VTE hospitalization rates also varied by geographic region. The hospitalization rate was highest in the East region (52.2 per 100,000) and lowest in the Alaska region (16.1 per 100,000). These data indicate that the overall VTE rate for AI/ANs may not have only decreased, but appears lower than the reported rate for Caucasians.
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