Venous thromboembolism: epidemiological, medico-social and economic aspects

Authors

  • GROSU Aurel IMSP Institutul de Cardiologie, Departamentul urgențe cardiace

DOI:

https://doi.org/10.52692/1857-0011.2022.1-72.12

Keywords:

venous thrombosis, pulmonary embolism, thrombosis risk factors

Abstract

Venous thromboembolism (VTE) includes thrombosis of the deep veins of the lower limbs or pelvis and its complication of pulmonary embolism (PE). VTE is common in clinical practice, especially in the elderly and is associated with low survival, substantial costs for care, a high recurrence rate. The disease is complex (multifactorial), which involves interactions between acquired or inherited predispositions for thrombosis. Major risk factors for venous thrombosis include hospitalization for surgery or acute illness, active cancer, neurological disease with neurological deficiencies, trauma or fractures, superficial and specific venous thrombosis for women - pregnancy and puerperium, oral contraception and hormone therapy. Although independent risk factors for venous thrombosis are currently identified, predictors of recurrence, effective remedies are available for primary and secondary prophylaxis, the incidence of VTE remains constant, or even increasing. This paper reflects current information on the epidemiology of venous thromboembolism and risk factors, incidence and recurrence trends, survival, healthcare costs

Author Biography

GROSU Aurel, IMSP Institutul de Cardiologie, Departamentul urgențe cardiace

doctor habilitat în medicină, profesor universitar

References

Alexander T. Cohen et al. Venous thromboembolism (VTE) in Europe.The number of VTE events and associated morbidity and mortality. Thromb Haemost. 2007; 98: 756–764

Heit JA. Epidemiology of venous thromboembolism. Nat Rev Cardiol. 2015; 12(8): 464–474 2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS). Euro Heart J. 2020; 41,543-603

Koton S. et al. Stroke incidence and mortality trends in US communities, 1987 to 2011. JAMA. 2014;312:259–268.

Kahn SR., Ducruet T., Lamping DL., Arsenault L., Miron MJ., Roussin A. et al. Prospective evaluation of health-related quality of life in patients with deep venous thrombosis. Arch Intern Med. 2005;165:1173–1178

Cushman M., Tsai AW., White RH., Heckbert SR., Rosamond WD, Enright P. et al. Deep vein thrombosis and pulmonary embolism in two cohorts: the Longitudinal Investigation of Thromboembolism Etiology. Am J Med. 2004;117:19–25

Heit JA., Silverstein MD., Mohr DN., Petterson TM., O’Fallon WM., Melton LJ. Predictors of survival after deep vein thrombosis and pulmonary embolism: a population-based cohort study. Arch Intern Med. 1999;159:445–453

Tsai AW., Cushman M., Rosamond WD., Heckbert SR., Polak JF., Folsom AR. Cardiovascular risk factors and venous thromboembolism incidence: the Longitudinal Investigation of Thromboembolism Etiology. Arch Intern Med. 2002;162:1182–1189.

Stein PD., Kayali F., Olson RE., Milford CE. Pulmonary thromboembolism in Asians/Pacific Islanders in the United States: analysis of data from the National Hospital Discharge Survey and the United States Bureau of the Census. Am J Med. 2004;116:435–442

Cushman M. Epidemiology and Risk Factors for Venous Thrombosis, Semin Hematol. 2007; 44(2): 62–69

Lutsey PL., Cushman M., Steffen LM., Green D., Barr RG., Herrington D., et al. Plasma hemostatic factors and endothelial markers in four racial/ethnic groups: the MESA study. J. Thromb Haemost. 2006;4:2629–2635.

Huang W., Goldberg RJ., Anderson FA., Kiefe CI., Spencer FA. Secular trends in occurrence of acute venous thromboembolism: the Worcester VTE study (1985–2009) Am. J. Med. 2014;127:829.e5–839.e5.

Stein PD., Beemath A., Olson RE. Obesity as a risk factor in venous thromboembolism. Am J Med. 2005;118:978–980.

Abdollahi M., Cushman M., Rosendaal FR. Obesity: risk of venous thrombosis and the interaction with coagulation factor levels and oral contraceptive use. Thromb Haemost. 2003;89:493–498.

Cushman M., Kuller LH., Prentice R., Rodabough RJ., Psaty BM., Stafford RS. et al. Estrogen plus progestin and risk of venous thrombosis. Jama. 2004;292:1573–1580.

den Heijer M., Willems HP., Blom HJ., Gerrits WB., Cattaneo M., Eichinger S. et al. Homocysteine lowering by B vitamins and the secondary prevention of deep vein thrombosis and pulmonary embolism: A randomized, placebo-controlled, double-blind trial. Blood. 2007;109:139–144.

Geerts WH., Pineo GF, Heit JA., Bergqvist D., Lassen MR., Colwell CW. et al. Prev.ention of venous thromboembolism: the Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. Chest. 2004;126:338S–400S.

White RH., Zhou H., Gage BF. Effect of age on the incidence of venous thromboembolism after major surgery. J Thromb Haemost. 2004;2:1327–1333

Blom JW., Vanderschoot JP., Oostindier MJ., Osanto S, van der Meer FJ, Rosendaal FR. Incidence of

venous thrombosis in a large cohort of 66,329 cancer patients: results of a record linkage study. J Thromb Haemost. 2006;4:529–535

Perez-Rodriguez E., Jimenez D., Diaz G., Perez-Walton I., Luque M., Guillen C. et al. Incidence of air travel-related pulmonary embolism at the Madrid-Barajas airport. Arch Intern Med. 2003;163:2766–2770

van Stralen KJ., Blom JW., Doggen CJ., Rosendaal FR. Strenuous sport activities involving the upper extremities increase the risk of venous thrombosis of the arm. J Thromb Haemost. 2005;3:2110–2111

Beasley R., Raymond N., Hill S., Nowitz M., Hughes R. eThrombosis: the 21st century variant of venous thromboembolism associated with immobility. Eur Respir J. 2003;21:374–376

Steffen LM., Folsom AR., Cushman M., Jacobs DR, Jr., Rosamond WD. Greater fish, fruit, and vegetable intakes are related to lower incidence of venous thromboembolism: the Longitudinal Investigation of Thromboembolism Etiology. Circulation. 2007;115:188–195

Prandoni P., Bilora F., Marchiori A., Bernardi E., Petrobelli F., Lensing AW. et al. An association between atherosclerosis and venous thrombosis. N Engl J Med. 2003;348:1435–1441

Wichmann D.et al. Autopsy findings and venous thromboembolism in patients with COVID-19. Ann. Intern. Med. 2020 doi: 10.7326/M20-2003

Angelo P. et al., Venous thromboembolism in patients with COVID-19: Systematic review and meta-analysis. Thromb Res. 2020; 196: 67–74.

Vandenbroucke JP., Koster T., Briet E., Reitsma PH., Bertina RM., Rosendaal FR. Increased risk of venous thrombosis in oral-contraceptive users who are carriers of factor V Leiden mutation. Lancet. 1994;344:1453–1457

Spencer FA., et al. Incidence rates, clinical profile, and outcomes of patients with venous thromboembolism. The Worcester VTE study. J. Thromb. Thrombolysis. 2009;28:401–409

Heit JA. et al. Predictors of recurrence after deep vein thrombosis and pulmonary embolism: a population-based cohort study. Arch. Intern. Med. 2000;160:761–768

Kovacs MJ., et al. Patients with a first symptomatic unprovoked deep vein thrombosis are at higher risk of recurrent venous thromboembolism than patients with a first unprovoked pulmonary embolism. J. Thromb. Haemost. 2010;8:1926–1932.

Biere-Rafi S. et al. Statin treatment and the risk of recurrent pulmonary embolism. Eur. Heart J. 2013;34:1800–1806

den Exter PL., et al. Risk profile and clinical outcome of symptomatic subsegmental acute pulmonary embolism. Blood. 2013;122:1144–1149

Baglin T. Management of thrombophilia: who to screen? Pathophysiol Haemost Thromb. 2003;33:401–404.

Christiansen SC., Cannegieter SC., Koster T., Vandenbroucke JP., Rosendaal FR. Thrombophilia, clinical factors, and recurrent venous thrombotic events. Jama. 2005;293:2352–2361

Shrivastava S., Ridker PM., Glynn RJ., Goldhaber SZ. Moll S, Bounameaux H, et al. D-dimer, factor VIII coagulant activity, low-intensity warfarin and the risk of recurrent venous thromboembolism. J Thromb Haemost. 2006;4:1208–1214.

Kahn SR., Ginsberg JS. The post-thrombotic syndrome: current knowledge, controversies, and directions for future research. Blood Rev. 2002;16:155–165

Cohoon KP., et al. Costs of venous thromboembolism associated with hospitalization for medical illness. Am. J. Manag. Care. 2015;21:e255–e263.

Oscar Miro et al., Pulmonary embolism in patients with COVID-19: incidence, risk factors, clinical characteristics, and outcome. Euro Heart J. 2021 00, 1–16

Alex C. Spyropoulos, Mark Goldin et al., HEP-COVID Trial, Systemic Anticoagulation With Full Dose Low Molecular Weight Heparin (LMWH) vs. Prophylactic or Intermediate Dose LMWH in High Risk COVID-19 Patients. ESC Congress 2021.

Published

2022-04-08

Issue

Section

Research Article