[Venous thromboembolism: epidemiology and risk factors]

The prevalence of DVT in the general community has been estimated from large descriptive studies of symptomatic patients; the annual incidence of proximal DVT has been reported to be 48 cases for 100,000. When associated to known risk factors, the incidence of DVT is strongly elevated; postoperative DVT occurs, for instance, in 5% to 40% of patients undergoing surgical procedures. Estimated of the incidence and prevalence of PE are less reliable than for DVT because the ante-morten diagnosis of PE is difficult and the post-mortem diagnosis highly selective. An analysis conducted on 11,000 autopsies showed that 316 of these had macroscopic pulmonary emboli; nevertheless, 11% of cases only had the diagnosis before death, while 32% of the patients were diagnosed as died of myocardial infarction, 15% of cerebrovascular disease and 14% of pneumonia. Update results, indicate that mortality due to PE is the first cause of death in hospitalized patients. Venous thromboembolism is a common disease often misdiagnosed because of low accuracy of clinical diagnosis; correct approaches for prophylaxis, therapy and to diagnosis are necessary to manage high-risk patients for DVT and/or PE and to reduce costs and social impact.