Venous thromboembolism: disease burden, outcomes and risk factors
Venous thromboembolism: disease burden, outcomes and risk factors
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DOI：
10.1111/j.1538-7836.2005.01415.x
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发表时间：
2005-08-01
影响因子：
10.4
通讯作者：
Heit, JA
中科院分区：
文献类型：
--
作者：
Heit, JA
社区静脉血栓栓塞症（VTE）的流行病学对VTE的预防和管理具有重要意义。本文综述了社区深静脉血栓形成和肺栓塞的疾病负担（发病率）、结局（生存率、复发率和并发症）和危险因素。回顾了最近对VTE流行病学的全面研究，这些研究报告了种族人口统计学，包括在一个明确定义的地理区域内随时间推移发生的疾病的全谱，并按事件类型、事件与复发事件以及诊断确定性水平进行了分类。VTE结局研究必须包括相关的随访持续时间。欧洲裔白人的静脉血栓栓塞发病率超过1/1000;非洲裔和亚洲裔人的发病率可能分别较高和较低。最近一段时间的VTE发病率保持不变。VTE后的生存率比预期的要差，尤其是肺栓塞。30%的患者发生VTE复发和静脉瘀血综合征。暴露可以识别处于风险中的人群，但对个体的预测价值较低。获得性或家族性血栓形成倾向可预测实际发生症状性静脉血栓栓塞的暴露人群亚组。总之，静脉血栓栓塞是一种常见的致命疾病，经常复发，并导致严重的长期并发症。为了提高生存率和预防并发症，必须减少VTE的发生。需要更好的个体风险分层，以改变暴露，并将主要和次要预防针对受益最大的人。
The epidemiology of venous thromboembolism (VTE) in the community has important implications for VTE prevention and management. This review describes the disease burden (incidence), outcomes (survival, recurrence and complications) and risk factors for deep vein thrombosis and pulmonary embolism occurring in the community. Recent comprehensive studies of the epidemiology of VTE that reported the racial demography and included the full spectrum of disease occurring within a well-defined geographic area over time, separated by event type, incident vs. recurrent event and level of diagnostic certainty, were reviewed. Studies of VTE outcomes had to include a relevant duration of follow-up. VTE incidence among whites of European origin exceeded I per 1000; the incidence among persons of African and Asian origin may be higher and lower, respectively. VTE incidence over recent time remains unchanged. Survival after VTE is worse than expected, especially for pulmonary embolism. Thirty percent of patients develop VTE recurrence and venous stasis syndrome. Exposures can identify populations at risk but have a low predictive value for the individual. An acquired or familial thrombophilia may predict the subset of exposed persons who actually develop symptomatic VTE. In conclusion, VTE is a common, lethal disease that recurs frequently and causes serious long-term complications. To improve survival and prevent complications, VTE occurrence must be reduced. Better individual risk stratification is needed in order to modify exposures and target primary and secondary prophylaxis to the person who would benefit most.