Relationship between neighborhood socioeconomic status and venous thromboembolism: results from a population‐based study

Abstract

Background The association between socioeconomic status and arterial cardiovascular disease is well established. However, despite its high burden of disability-adjusted life years, little research has been carried out to determine whether socioeconomic status is associated with venous thromboembolism. Objective To determine if neighborhood socioeconomic status is associated with venous thromboembolism in a population-based study from the Netherlands. Methods We identified all patients aged 15 years and older with a first event of venous thromboembolism from inhabitants who lived in the urban districts of The Hague, Leiden and Utrecht in the Netherlands in 2008-2012. Neighborhood socioeconomic status was based on the status score, which combines educational level, income and unemployment on a four-digit postal code level. Incidence rate ratios of venous thromboembolism were calculated for different levels of neighborhood socioeconomic status, with adjustments for age and sex. Results A total of 7373 patients with a first venous thromboembolism (median age 61 years; 50% deep vein thrombosis) were identified among more than 1.4 million inhabitants. Higher neighborhood SES was associated with lower incidence of VTE. In the two highest status score groups (i.e. the 95-99th and > 99th percentile), the adjusted incidence rate ratios were 0.91 (95% confidence interval [CI], 0.84-1.00) and 0.80 (95% CI, 0.69-0.93), respectively, compared with the reference status score group (i.e. 30-70th percentile). Conclusions High neighborhood socioeconomic status is associated with a lower risk of first venous thromboembolism.

COVID-19 and Thrombotic or Thromboembolic Disease: Implications for Prevention, Antithrombotic Therapy, and Follow-Up

“…These losses may adversely affect patients' treatment for thrombotic diseases. Socioeconomic disadvantage has been linked to higher rates of VTE and adverse outcomes (140,141). As the economic effects of COVID-19 continue to evolve, these communities may come under new and significant stress.…”

Current and future burden of venous thrombosis: Not simply predictable

“…To investigate the incidence of first venous thrombosis events over calendar time in the Netherlands, we conducted a dynamic population‐based study between 2003 and 2012, as was previously described by Kort et al . Since only patients treated with vitamin K antagonists are included in the study, patients using long term low‐molecular‐weight heparins for venous thrombosis treatment (such as patients with a malignancy or pregnant patients) are underrepresented.…”

“…21 In the Norwegian Tromsø study, in which 26 855 persons aged 25-97 were followed from 1994/1995 throughout 2012, the incidence of a first symptomatic venous thrombosis (based on 693 events) increased from 15.8 (95% CI 11.6-19.9) per 10 000 persons years in 1996 and 1997 to 20.1 (95% CI 16.0-24.3) in 2010 and 2011. 22 To investigate the incidence of first venous thrombosis events over calendar time in the Netherlands, we conducted a dynamic population-based study between 2003 and 2012, as was previously described by Kort et al 23,24 Since only patients treated with vitamin K antagonists are included in the study, patients using long term low-molecular-weight heparins for venous thrombosis treatment (such as patients with a malignancy or pregnant patients) are underrepresented. Patients who died as a result of or shortly after the event are therefore neither in the study.…”

A phenome-wide approach to identify causal risk factors for deep vein thrombosis

“…Previous research has highlighted that a lower socioeconomic status is associated with a decrease in school performance (43), and that this in turn is associated an increased incidence of VTE (44).…”