Venous thromboembolism (VTE) in Europe - The number of VTE events and associated morbidity and mortality
Venous thromboembolism (VTE) in Europe - The number of VTE events and associated morbidity and mortality
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DOI：
10.1160/th07-03-0212
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发表时间：
2007-10-01
影响因子：
6.7
通讯作者：
Spannagl, Michael
中科院分区：
文献类型：
--
作者：
Cohen, Alexander T.;Agnelli, Giancarlo;Spannagl, Michael
静脉血栓栓塞（VTE）通常无症状、误诊、死亡时未被识别，并且缺乏常规尸检。这些因素被认为会导致 VTE 发生率明显低估。我们研究的目的是估算欧盟 (EU) 每年 VTE 的总负担。构建了流行病学模型来估计欧盟每年发生的社区和医院获得性事件和非致命性 VTE 和 VTE 相关死亡的复发病例（发病率）数量，以及血栓后综合征 (PTS) 和慢性血栓栓塞性肺动脉高压 (PH) 的事件和流行病例数。为六个欧盟国家开发了单独的模型。这些模型填充了来自已发表文献的数据，并在必要时添加了专家意见。使用概率敏感性分析对研究结果进行了测试。六个欧盟国家每年估计有症状 VTE 事件总数（范围基于概率敏感性分析）为 465,715 (404,664-538,189) 例深静脉血栓形成病例、295,982 (242,450-360,363) 例肺栓塞 (PE) 病例和 370,012 例(300,193-483,108) 与 VTE 相关的死亡。在这些死亡中，估计有 27,473 人 (7%) 被诊断为生前死亡； 126,145 例 (34%) 为突发致命性肺栓塞，217,394 例 (59%) 为未确诊肺栓塞。所有与 VTE 相关的死亡中，近四分之三是由医院获得性 VTE 引起的。VTE 是欧盟的一个主要健康问题，在接受调查的六个国家中，每年有超过 100 万例 VTE 事件或死亡。鉴于有效的 VTE 预防措施的存在，许多此类事件和死亡本来是可以预防的。这些结果对医疗资源的分配具有重要意义。
Venous thromboembolism (VTE) is often asymptomatic, mis-diagnosed, and unrecognized at death, and there is a lack of routine postmortem examinations. These factors are thought to result in marked underestimates ofVTE incidence. The objective of our study was to estimate the total burden of VTE within the European Union (EU) per annum. An epidemiological model was constructed to estimate the number of community- and hospital-acquired incidents and recurrent cases (attack rate) of nonfatal VTE and VTE-related deaths, as well as incident and prevalent cases of post-thrombotic syndrome (PTS) and chronic thromboembolic pulmonary hypertension (PH) occurring in the EU per annum. Individual models were developed for six EU countries. The models were populated with data from published literature and, where necessary, expert opinions. The findings were tested using probabilistic sensitivity analyses. The estimated total number of symptomaticVTE events (range based on probabilistic sensitivity analysis) per annum within the six EU countries was 465,715 (404,664-538,189) cases of deep-vein thrombosis, 295,982 (242,450-360,363) cases of pulmonary embolism (PE), and 370,012 (300,193-483,108) VTE-related deaths. Of these deaths, an estimated 27,473 (7%) were diagnosed as being antemortem; 126,145 (34%) were sudden fatal PE, and 217,394 (59%) followed undiagnosed PE.Almost threequarters of all VTE-related deaths were from hospital-acquired VTE.VTE is a major health problem in the EU, with over one million VTE events or deaths per annum in the six countries examined. Given the availability of effective VTE prophylaxis, many of these events and deaths could have been prevented. These results have important implications for the allocation of healthcare resources.