TY - JOUR
T1 - Venous thromboembolism (VTE) in Europe - The number of VTE events and associated morbidity and mortality
AU - Cohen, Alexander T.
AU - Agnelli, Giancarlo
AU - Anderson, Frederick A.
AU - Arcelus, Juan I.
AU - Bergqvist, David
AU - Brecht, Josef G.
AU - Greer, Ian A.
AU - Heit, John A.
AU - Hutchinson, Julia L.
AU - Kakkar, Ajay K.
AU - Mottier, Dominique
AU - Oger, Emmanuel
AU - Samama, Meyer Michel
AU - Spannagl, Michael
PY - 2007/10
Y1 - 2007/10
N2 - Venous thromboembolism (VTE) is often asymptomatic, misdiagnosed, and unrecognized at death, and there is a lack of routine postmortem examinations. These factors are thought to result in marked underestimates of VTE incidence. The objective of our study was to estimate the total burden of VTE within the European Union (EU) per annum. An epidemiological model was constructed to estimate the number of community- and hospital-acquired incidents and recurrent cases (attack rate) of non-fatal VTE and VTE-related deaths, as well as incident and prevalent cases of post-thrombotic syndrome (PTS) and chronic thromboembolic pulmonary hypertension (PH) occurring in the EU per annum. Individual models were developed for six EU countries. The models were populated with data from published literature and, where necessary, expert opinions. The findings were tested using probabilistic sensitivity analyses. The estimated total number of symptomatic VTE events (range based on probabilistic sensitivity analysis) per annum within the six EU countries was 465,715 (404,664-538,189) cases of deep-vein thrombosis, 295,982 (242,450-360,363) cases of pulmonary embolism (PE), and 370,012 (300,193-483,108) VTE-related deaths. Of these deaths, an estimated 27,473 (7%) were diagnosed as being antemortem; 126,145 (34%) were sudden fatal PE, and 217,394 (59%) followed undiagnosed PE. Almost three-quarters of all VTE-related deaths were from hospital-acquired VTE. VTE is a major health problem in the EU, with over one million VTE events or deaths per annum in the six countries examined. Given the availability of effective VTE prophylaxis, many of these events and deaths could have been prevented. These results have important implications for the allocation of healthcare resources.
AB - Venous thromboembolism (VTE) is often asymptomatic, misdiagnosed, and unrecognized at death, and there is a lack of routine postmortem examinations. These factors are thought to result in marked underestimates of VTE incidence. The objective of our study was to estimate the total burden of VTE within the European Union (EU) per annum. An epidemiological model was constructed to estimate the number of community- and hospital-acquired incidents and recurrent cases (attack rate) of non-fatal VTE and VTE-related deaths, as well as incident and prevalent cases of post-thrombotic syndrome (PTS) and chronic thromboembolic pulmonary hypertension (PH) occurring in the EU per annum. Individual models were developed for six EU countries. The models were populated with data from published literature and, where necessary, expert opinions. The findings were tested using probabilistic sensitivity analyses. The estimated total number of symptomatic VTE events (range based on probabilistic sensitivity analysis) per annum within the six EU countries was 465,715 (404,664-538,189) cases of deep-vein thrombosis, 295,982 (242,450-360,363) cases of pulmonary embolism (PE), and 370,012 (300,193-483,108) VTE-related deaths. Of these deaths, an estimated 27,473 (7%) were diagnosed as being antemortem; 126,145 (34%) were sudden fatal PE, and 217,394 (59%) followed undiagnosed PE. Almost three-quarters of all VTE-related deaths were from hospital-acquired VTE. VTE is a major health problem in the EU, with over one million VTE events or deaths per annum in the six countries examined. Given the availability of effective VTE prophylaxis, many of these events and deaths could have been prevented. These results have important implications for the allocation of healthcare resources.
KW - Deep-vein thrombosis
KW - Post-thrombotic syndrome
KW - Pulmonary embolism
KW - Pulmonary hypertension
KW - VTE prophylaxis
KW - Venous thromboembolism
UR - http://www.scopus.com/inward/record.url?scp=35048860791&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=35048860791&partnerID=8YFLogxK
U2 - 10.1160/TH07-03-0212
DO - 10.1160/TH07-03-0212
M3 - Article
C2 - 17938798
AN - SCOPUS:35048860791
SN - 0340-6245
VL - 98
SP - 756
EP - 764
JO - Thrombosis and Haemostasis
JF - Thrombosis and Haemostasis
IS - 4
ER -