Epidemiology of first and recurrent venous thromboembolism: A population-based cohort study in patients without active cancer

Abstract

Contemporary data from population studies on the incidence and complications of venous thromboembolism (VTE) are limited. An observational cohort study was undertaken to estimate the incidence of first and recurrent VTE. The cohort was identified from all patients in the UK Clinical Practice Research Datalink (CPRD) with additional linked information on hospitalisation and cause of death. Between 2001 and 2011, patients with first VTE were identified and the subset without active cancer-related VTE observed for up to 10 years for recurrent VTE. The 10-year cumulative incidence rates (CIR) were derived with adjustment for mortality as a competing risk event. A total of 35,373 first VTE events (12,073 provoked, 16,708 unprovoked and 6592 active cancer-associated VTE) among 26.9 million person-years of observation were identified. The overall incidence rate (IR) of VTE was 131.5 (95% CI, 130.2-132.9) per 100,000 person-years and 107.0 (95% CI, 105.8-108.2) after excluding cancer-associated VTE. DVT was more common in the young and PE was more common in the elderly. VTE recurrence occurred in 3671 (CIR 25.2%). The IR for recurrence peaked in the first six months at around 11 per 100 person years. It levelled out after three years and then remained at around 2 per 100 person years from year 4-10 of follow-up. The IRs for recurrences were particularly high in young men. In conclusion, VTE is common and associated with high recurrence rates. Effort is required to prevent VTE and to reduce recurrences.

Testosterone treatment and risk of venous thromboembolism: population based case-control study

“…The strengths of this study include the use of a validated venous thromboembolism algorithm, a non-venous thromboembolism cohort matched on known and suspected confounding factors that are or may be causes of prescriptions for testosterone or of venous thromboembolism, and the availability of full prescription data allowing investigation of risk of venous thromboembolism by time since starting or stopping testosterone treatment 22. In addition, we were able to adjust for other potential confounders known to be associated with the risk of future venous thromboembolism and to reduce confounding by indication by matching on history of hypogonadism.…”

“…We applied a validated algorithm for venous thromboembolism to identify the first occurrence 22. Venous thromboembolism comprised pulmonary embolism and deep vein thrombosis.…”

“…The sensitivity for detecting venous thromboembolism was 92.6%, and the specificity was 98.6% 22. The first occurrence of VTE during the study period defined the case, and we designated the date of this event as the index date.…”

The Relationship between Leukocyte Counts and Venous Thromboembolism: Results from RETROVE Study

“…Some studies [15,22] reported an equal prevalence of spontaneous and non-spontaneous VTE. However, we observed a high prevalence of spontaneous VTE (68.3%) versus non-spontaneous (31.8%).…”

“…Any type of thrombosis was included except those related to cancer. VTE was classified as either unprovoked or spontaneous or provoked or nonspontaneous (one or more provoking factors within 3 months previous to an event) [15,16]. In this last group, provoking factors were: surgery, immobilization, pregnancy, oral contraceptive, prothrombotic nonneoplastic diseases and others.…”