Secular trends in occurrence of acute venous thromboembolism: the Worcester VTE study (1985-2009).
Secular trends in occurrence of acute venous thromboembolism: the Worcester VTE study (1985-2009).
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DOI：
10.1016/j.amjmed.2014.03.041
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发表时间：
2014-09
影响因子：
5.9
通讯作者：
Spencer, Frederick A.
中科院分区：
文献类型：
--
作者：
Huang, Wei;Goldberg, Robert J.;Anderson, Frederick A.;Kiefe, Catarina I.;Spencer, Frederick A.
由于识别、预防和治疗方面的进步，静脉血栓栓塞的临床流行病学最近发生了变化。我们试图描述马萨诸塞州伍斯特大都会统计区 (WMSA) 居民静脉血栓栓塞发生的长期趋势。采用基于人群的方法监测 1985 年至 2009 年 9 年间诊断患有急性肺栓塞和/或下肢深静脉血栓的 5025 名 WMSA 居民的首次或复发静脉血栓栓塞事件发生率趋势。医疗记录由摘要者审查并由临床医生验证。经过年龄和性别调整的首次静脉血栓栓塞的年度事件发生率从 1985/1986 年的每 10 万人 73 例（95% CI 64-82）增加到 2009 年的 133 例（122-143），这主要是由于肺栓塞的增加。静脉血栓栓塞复发率从 1985/1986 年的 39 例（32-45 例）下降到 2003 年的 19 例（15-23 例），然后又增加到 2009 年的 35 例（29-40 例）。使用非侵入性诊断检测有增加的趋势，1985/1986 年大约一半的检测是侵入性的，而 2009 年几乎所有检测都是非侵入性的。 2009年。尽管1985年至2009年间在识别、预防和治疗方面取得了进展，但静脉血栓栓塞的年度事件发生率有所增加并仍然很高。虽然这些增加可能部分是由于诊断方法的敏感性增加，特别是对于肺栓塞，但这也可能意味着当前的预防和治疗策略并非最佳。
The clinical epidemiology of venous thromboembolism has changed recently due to advances in identification, prophylaxis, and treatment. We sought to describe secular trends in occurrence of venous thromboembolism among residents of the Worcester, Massachusetts, metropolitan statistical area (WMSA). Population-based methods were used to monitor trends in event rates of first-time or recurrent venous thromboembolism in 5025 WMSA residents diagnosed with acute pulmonary embolism and/or lower-extremity deep vein thrombosis during 9 annual periods between 1985 and 2009. Medical records were reviewed by abstractors and validated by clinicians. Age- and sex-adjusted annual event rates for first-time venous thromboembolism increased from 73 (95% CI 64–82) per 100,000 in 1985/1986 to 133 (122–143) in 2009, due mostly to an increase in pulmonary embolism. The rate of recurrent venous thromboembolism decreased from 39 (32–45) in 1985/1986 to 19 (15–23) in 2003, and then increased to 35 (29–40) in 2009. There was an increasing trend in using non-invasive diagnostic testing, with about half of tests being invasive in 1985/1986 and almost all non-invasive by 2009. Despite advances in identification, prophylaxis, and treatment between 1985 and 2009, the annual event rate of venous thromboembolism has increased and remains high. While these increases may be partially due to increased sensitivity of diagnostic methods, especially for pulmonary embolism, it may also imply that current prevention and treatment strategies are less than optimal.
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影响因子：
5.9
作者：
Spencer, Frederick A.;Emery, Cathy;Goldberg, Robert J.
通讯作者：
Goldberg, Robert J.
影响因子：
9.6
作者：
Geerts, WH;Pineo, GF;Ray, JG
通讯作者：
Ray, JG
影响因子：
9.6
作者：
Park, Brian;Messina, Louis;Anderson, Frederick A.
通讯作者：
Anderson, Frederick A.
影响因子：
10.4
作者：
Heit, JA
通讯作者：
Heit, JA
影响因子：
158.5
作者：
Ridker, PM;Goldhaber, SZ;Boross-Harmer, S
通讯作者：
Boross-Harmer, S