Incidence of venous thromboembolism in hospitalized patients vs community residents
Incidence of venous thromboembolism in hospitalized patients vs community residents
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DOI：
10.4065/76.11.1102
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发表时间：
2001-11-01
影响因子：
8.9
通讯作者：
O'Fallon, WM
中科院分区：
文献类型：
--
作者：
Heit, JA;Melton, LJ;O'Fallon, WM
目的：估计住院患者深静脉血栓形成（DVT）和肺栓塞（PE）的发病率，并将其与社区居民的发病率进行比较。患者和方法：我们对1980年至1990年居住在明尼苏达州奥姆斯特德县的患者的完整医疗记录进行了回顾性分析。从1980年到1990年，911名奥姆斯特德县居民经历了他们的第一次明确的，很可能的，或可能的静脉血栓栓塞事件。在这些居民中，253人因DVT或PE诊断以外的某种原因住院（住院病例），658人在静脉血栓栓塞发作时未住院（社区居民）。经年龄和性别校正的院内静脉血栓栓塞的平均年发病率为960.5（95%置信区间，795.1-1125.9）/10,000人-年，比社区居民的发病率7.1（95%置信区间，6.57.6）/10,000人-年高100倍以上。两组的静脉血栓栓塞发生率均随年龄增长而显著升高，住院病例中与年龄相关的增加大部分为PE。尽管1980年至1990年平均住院时间缩短，但两组的发病率随时间变化不大。结论：静脉血栓栓塞是一个主要的国家健康问题，尤其是在老年住院患者中。这一发现强调需要准确识别有静脉血栓栓塞风险的住院患者，并更好地了解所涉及的机制，以便实施安全有效的预防措施。
Objective: To estimate the incidence rates of deep venous thrombosis (DVT) and pulmonary embolism (PE) in hospitalized patients and to compare these with incidence rates in community residents.Patients and Methods: We performed a retrospective review of the complete medical records from a population-based inception cohort of patients who resided in Olmsted County, Minnesota, and had an incident DVT or PE from 1980 through 1990.Results: From 1980 through 1990, 911 Olmsted County residents experienced their first lifetime event of definite, probable, or possible venous thromboembolism. Of these residents, 253 had been hospitalized for some reason other than a diagnosis of DVT or PE (in-hospital cases), and 658 were not hospitalized at onset of venous thromboembolism (community residents). The average annual age- and sex-adjusted incidence of in-hospital venous thromboembolism was 960.5 (95% confidence interval, 795.1-1125.9) per 10,000 person-years and was more than 100 times greater than the incidence among community residents at 7.1 (95% confidence interval, 6.57.6) per 10,000 person-years. The incidence of venous thromboembolism rose markedly with increasing age for both groups, with PE accounting for most of the age-related increase among in-hospital cases. Incidence rates in the 2 groups changed little over time despite a reduction in the average length of hospital stay between 1980 and 1990.Conclusions: Venous thromboembolism is a major national health problem, especially among elderly hospitalized patients. This finding emphasizes the need for accurate identification of hospitalized patients at risk for venous thromboembolism and a better understanding of the mechanisms involved so that safe and effective prophylaxis can be implemented.