Seasonal variations in hospital admission for deep vein thrombosis and pulmonary embolism: analysis of discharge data

Boulay, Fabrice; Berthier, F.; Schoukroun, Grégory; Raybaut, Charles; Gendreike, Y.; Blaive, B

doi:10.1136/bmj.323.7313.601

Cited by 89 publications

(76 citation statements)

References 4 publications

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“…4,5,6,7 Another interesting finding in our data, consistent with a previous large French study of DVT and pulmonary embolus, and using a similar analysis, is a marked monthly variation in admissions for pulmonary embolus, with the greatest number of admission occurring in the winter months. 12 This differs from previous international studies which have not shown seasonal variation and this potential phenomena merits further investigation perhaps through linkage of detailed meteorological data to patient records. 13,14 One potential explanation for the seasonal data may relate to changes in thrombotic tendency related to seasonal changes or infection.…”

Section: Discussioncontrasting

confidence: 48%

Trends in hospital admissions for pulmonary embolism in England: 1996/7 to 2005/6

et al. 2008

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-Pulmonary embolism (PE) can be difficult to diagnose and manage. This paper examines recent national trends in admission rates and mortality for PE to help inform clinical practice. Admissions to NHS hospitals in England between 1 April 1996 and 31 March 2006 were studied. Trends in admission rates, the proportion of all admissions with PE as primary or secondary diagnosis and hospital mortality following PE identified. There were 251,449 admissions with a diagnosis of pulmonary embolus in the study period. Non-elective admission rates rose from 28.0 per 100,000 in 1996/7 to 32.1 per 100,000 in 2005/6. There was a significant increase in secondary diagnosis rates and a clear seasonal pattern with excess admissions in winter. There was significant in-hospital mortality for both primary (13%) and secondary diagnosis (31%). Mortality decreased over time and was highest among the elderly. Pulmonary embolism is associated with a significant mortality although overall trends in mortality are improving in England. Age and comorbidities must be considered when developing guidelines and individual treatment plans.

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Section: Discussioncontrasting

confidence: 48%

Trends in hospital admissions for pulmonary embolism in England: 1996/7 to 2005/6

et al. 2008

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“…11 Using a large French discharge data set (nϭ127,318), Boulay et al found 10% to 15% more admissions during winter months and 10% to 15% fewer admission during the summer. 26 Additional studies are needed to confirm this finding. Assuming the amount of physical activity in a population decreases in the winter, it is possible that this finding demonstrates an inverse relationship between physical activity and development of VTE.…”

Section: Seasonal Variationmentioning

confidence: 68%

“…In the study reported by Hansson et al, the observed incidence was 132 per 100,000 population age 50 -59. 6 Among indi- Relative Incidence of PE vs DVT Absent autopsy diagnosis: Ϸ33% PE; 66% DVT 1,10 With autopsy: Ϸ55% PE, 45% DVT 2,6 Seasonal Variation Possibly more common in winter and less common in summer [24][25][26] Risk Factors Ϸ25% to 50% "idiopathic" depending on exact definition Ϸ15%-25% associated with cancer; Ϸ20% following surgery (3 mo.) 2,5,27 Recurrent VTE 6-month incidence: Ϸ7%; higher rate in patients with cancer 5,[28][29][30] Recurrent PE more likely after PE than after DVT 4,10,31 Death After Treated VTE 30 day incidence Ϸ6% after incident DVT, 2,5,10…”

Section: Effect Of Agementioning

confidence: 99%

The Epidemiology of Venous Thromboembolism

2003

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Abstract-Venous thromboembolism (VTE) occurs for the first time in Ϸ100 persons per 100,000 each year in the United States, and rises exponentially from Ͻ5 cases per 100,000 persons Ͻ15 years old to Ϸ500 cases (0.5%) per 100,000 persons at age 80 years. Approximately one third of patients with symptomatic VTE manifest pulmonary embolism (PE), whereas two thirds manifest deep vein thrombosis (DVT) alone. Despite anticoagulant therapy, VTE recurs frequently in the first few months after the initial event, with a recurrence rate of Ϸ7% at 6 months. Death occurs in Ϸ6% of DVT cases and 12% of PE cases within 1 month of diagnosis. The time of year may affect the occurrence of VTE, with a higher incidence in the winter than in the summer. One major risk factor for VTE is ethnicity, with a significantly higher incidence among Caucasians and African Americans than among Hispanic persons and AsianPacific Islanders. Overall, Ϸ25% to 50% of patient with first-time VTE have an idiopathic condition, without a readily identifiable risk factor. Early mortality after VTE is strongly associated with presentation as PE, advanced age, cancer, and underlying cardiovascular disease. Incidence of VTEA number of studies have focused specifically on the epidemiology of VTE. Anderson et al determined the incidence of VTE in Worcester, Massachusetts, over an 18-month period in the mid 1980s by reviewing the hospital discharge records of all patients coded as having VTE, including both recurrent and first-time episodes. The number of cases (nϭ405) was small, and 97% were Caucasian.

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“…However, in the literature there are reports of increased incidence of VTE in the winter months [1][2][3][4][5][6][7]. Increased incidence of DVT in the winter is being explained by some authors by changes in the coagulation system associated with the low temperature, which raises the tendency of thrombus formation, reduced venous flow in the legs as well as a vasoconstrictor effect of low temperatures on veins [5,14].…”

Section: Discussionmentioning

confidence: 99%

“…There are both reports of increased incidence of VTE in the winter months [1][2][3][4][5][6][7] and studies in which there was no seasonal incidence of deep vein thrombosis (DVT) [8][9][10] in current literature.…”

Section: Introductionmentioning

confidence: 99%