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The changing pattern of venous thromboembolic disease
A T Cohen1, R A Edmondson, M J Phillips
1Thrombosis Research Institute, Chelsea, UK.
Haemostasis
|March 1, 1996
Summary
Fatal pulmonary embolism and deep vein thrombosis (DVT) rates significantly decreased from 1965-1990. This suggests thromboprophylaxis and hospital practice changes effectively reduced DVT and related deaths.
Area of Science:
- Medical research
- Clinical epidemiology
- Thrombosis studies
Background:
- Pulmonary embolism and deep vein thrombosis (DVT) are significant causes of morbidity and mortality.
- Understanding trends in these conditions is crucial for public health and clinical practice.
Purpose of the Study:
- To analyze temporal trends in fatal pulmonary embolism and venographically diagnosed deep vein thrombosis (DVT) over a 25-year period.
- To investigate the impact of thromboprophylactic measures and hospital practice changes on these trends.
Main Methods:
- Retrospective review of 14,667 necropsy reports (1965-1990).
- Analysis of 6,436 diagnostic venograms (1976-1990).
- Statistical analysis using chi-squared tests for linear trend.
Main Results:
- A significant decrease in fatal pulmonary embolism reported at necropsy, from 6.1% to 2.1% (p < 0.00001).
- A significant reduction in venographically diagnosed postoperative deep vein thrombosis (DVT) rate from 49.9 to 24.7 per 100,000 population over the last decade (p < 0.0001).
- Non-postoperative DVT rates remained constant, contrasting with the decline in postoperative cases.
Conclusions:
- The introduction of thromboprophylactic measures and changes in hospital practice have significantly impacted the incidence of fatal pulmonary embolism and DVT.
- These interventions appear effective in reducing the burden of this serious, potentially avoidable disease.