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CC BY-NC-ND 4.0 · Thromb Haemost 2021; 121(06): 816-825
DOI: 10.1055/s-0040-1722189
Stroke, Systemic or Venous Thromboembolism

Incidence of Venous Thromboembolism in a Racially Diverse Population of Oklahoma County, Oklahoma

Aaron M. Wendelboe
1   Department of Biostatistics and Epidemiology, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, United States
,
Janis Campbell
1   Department of Biostatistics and Epidemiology, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, United States
,
Kai Ding
1   Department of Biostatistics and Epidemiology, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, United States
,
Dale W. Bratzler
2   Department of Health Administration and Policy, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, United States
,
Michele G. Beckman
2   Department of Health Administration and Policy, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, United States
,
Nimia L. Reyes
3   Division of Blood Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, United States
,
Gary E. Raskob
1   Department of Biostatistics and Epidemiology, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, United States
› Author Affiliations Funding This study was supported by the Centers for Disease Control and Prevention (Cooperative Agreement # 5U50DD000899-02). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention.
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Abstract

Background Contemporary incidence data for venous thromboembolism (VTE) from racially diverse populations are limited. The racial distribution of Oklahoma County closely mirrors that of the United States.

Objective To evaluate VTE incidence and mortality, including demographic and racial subgroups.

Design Population-based prospective study.

Setting We conducted VTE surveillance at all relevant tertiary care facilities and outpatient clinics in Oklahoma County, Oklahoma during 2012 to 2014, using both active and passive methods. Active surveillance involved reviewing all imaging reports used to diagnose VTE. Passive surveillance entailed identifying VTE events from hospital discharge data and death certificate records.

Measurements We used Poisson regression to calculate crude, age-stratified, and age-adjusted incidence and mortality rates per 1,000 population per year and 95% confidence intervals (CIs).

Results The incidence rate of all VTE was 3.02 (2.92–3.12) for those age ≥18 years and 0.05 (0.04–0.08) for those <18 years. The age-adjusted incidence rates of all VTE, deep vein thrombosis, and pulmonary embolism were 2.47 (95% CI: 2.39–2.55), 1.47 (1.41–1.54), and 0.99 (0.93–1.04), respectively. The age-adjusted VTE incidence and the 30-day mortality rates, respectively, were 0.63 and 0.121 for Asians/Pacific Islanders, 3.25 and 0.355 for blacks, 0.67 and 0.111 for Hispanics, 1.25 and 0.195 for Native Americans, and 2.71 and 0.396 for whites.

Conclusion The age-adjusted VTE incidence and mortality rates vary substantially by race. The incidence of three per 1,000 adults per year indicates an important disease burden, and is informative of the burden in the U.S. population.

Keywords

venous thromboembolism - pulmonary embolism - deep vein thrombosis - epidemiological studies - incidence rates

Supplementary Material



Publication History

Received: 19 September 2020

Accepted: 12 November 2020

Article published online:
10 January 2021

© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • References

  • 1 Kasper W, Konstantinides S, Geibel A. et al. Management strategies and determinants of outcome in acute major pulmonary embolism: results of a multicenter registry. J Am Coll Cardiol 1997; 30 (05) 1165-1171
    CrossrefPubMedGoogle Scholar
  • 2 Maynard G. Preventing Hospital-Associated Venous Thromboembolism: a Guide for Effective Quality Improvement. 2nd ed. Rockville, MD: Agency for Healthcare Research and Quality; 2016
    Google Scholar
  • 3 Agency for Healthcare Research and Quality. Postoperative pulmonary embolism or deep vein thrombosis rate: patient safety indicators #12. 2012 . Accessed October 2, 2017 at: https://www.qualityindicators.ahrq.gov/Downloads/Modules/PSI/V44/TechSpecs/PSI%2012%20Postoperative%20PE%20or%20DVT%20Rate.pdf
    PubMedGoogle Scholar
  • 4 Silverstein MD, Heit JA, Mohr DN, Petterson TM, O'Fallon WM, Melton III LJ. Trends in the incidence of deep vein thrombosis and pulmonary embolism: a 25-year population-based study. Arch Intern Med 1998; 158 (06) 585-593
    CrossrefPubMedGoogle Scholar
  • 5 Spencer FA, Emery C, Lessard D. et al. The Worcester Venous Thromboembolism study: a population-based study of the clinical epidemiology of venous thromboembolism. J Gen Intern Med 2006; 21 (07) 722-727
    CrossrefPubMedGoogle Scholar
  • 6 Wendelboe AM, Campbell J, McCumber M. et al. The design and implementation of a new surveillance system for venous thromboembolism using combined active and passive methods. Am Heart J 2015; 170 (03) 447.e18-454.e18
    CrossrefPubMedGoogle Scholar
  • 7 Centers for Disease Control and Prevention. HIPAA privacy rule and public health: guidance from CDC and the U.S. Department of Health and Human Services. MMWR Suppl 2003; 52: 1-17 , 9–20
    PubMedGoogle Scholar
  • 8 2013 American Community Survey. U.S. Census Bureau's American Community Survey Office, 2013. 2015 . Accessed December 4, 2020 at: https://data.census.gov/cedsci/table?t=Populations%20and%20People&g=0400000US40&y=2013&d=ACS%201-Year%20Estimates%20Data%20Profiles&tid=ACSDP1Y2013.DP05&hidePreview=false
    PubMedGoogle Scholar
  • 9 SEER*Stat Database: Populations - Total Oklahoma (2013). National Cancer Institute, DCCPS, 2013. Available at: 2015 https://seer.cancer.gov/stdpopulations/
    PubMedGoogle Scholar
  • 10 Kearon C, Ageno W, Cannegieter SC, Cosmi B, Geersing GJ, Kyrle PA. Subcommittees on Control of Anticoagulation, and Predictive and Diagnostic Variables in Thrombotic Disease. Categorization of patients as having provoked or unprovoked venous thromboembolism: guidance from the SSC of ISTH. J Thromb Haemost 2016; 14 (07) 1480-1483
    CrossrefPubMedGoogle Scholar
  • 11 Centers for Disease Control and Prevention (CDC). Venous thromboembolism in adult hospitalizations - United States, 2007-2009. Morb Mortal Wkly Rep 2012; 61 (22) 401-404
    PubMedGoogle Scholar
  • 12 Delluc A, Tromeur C, Le Ven F. et al; EPIGETBO study group. Current incidence of venous thromboembolism and comparison with 1998: a community-based study in Western France. Thromb Haemost 2016; 116 (05) 967-974
    Article in Thieme ConnectPubMedGoogle Scholar
  • 13 White RH, Zhou H, Murin S, Harvey D. Effect of ethnicity and gender on the incidence of venous thromboembolism in a diverse population in California in 1996. Thromb Haemost 2005; 93 (02) 298-305
    Article in Thieme ConnectPubMedGoogle Scholar
  • 14 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 (09) 829.e5-839.e5
    CrossrefPubMedGoogle Scholar
  • 15 Cohen AT, Agnelli G, Anderson FA. et al; VTE Impact Assessment Group in Europe (VITAE). Venous thromboembolism (VTE) in Europe. The number of VTE events and associated morbidity and mortality. Thromb Haemost 2007; 98 (04) 756-764
    Article in Thieme ConnectPubMedGoogle Scholar
  • 16 Anderson Jr FA, Wheeler HB, Goldberg RJ. et al. A population-based perspective of the hospital incidence and case-fatality rates of deep vein thrombosis and pulmonary embolism. The Worcester DVT Study. Arch Intern Med 1991; 151 (05) 933-938
    CrossrefPubMedGoogle Scholar
  • 17 Alotaibi GS, Wu C, Senthilselvan A, McMurtry MS. Secular trends in incidence and mortality of acute venous thromboembolism: the AB-VTE Population-Based Study. Am J Med 2016; 129 (08) 879.e19-879.e25
    CrossrefPubMedGoogle Scholar
  • 18 Tagalakis V, Patenaude V, Kahn SR, Suissa S. Incidence of and mortality from venous thromboembolism in a real-world population: the Q-VTE Study Cohort. Am J Med 2013; 126 (09) 832.e13-832.e21
    CrossrefPubMedGoogle Scholar
  • 19 Wiener RS, Schwartz LM, Woloshin S. Time trends in pulmonary embolism in the United States: evidence of overdiagnosis. Arch Intern Med 2011; 171 (09) 831-837
    CrossrefPubMedGoogle Scholar
  • 20 Barco S, Valerio L, Ageno W. et al. Age-sex specific pulmonary embolism-related mortality in the USA and Canada, 2000–18: an analysis of the WHO Mortality Database and of the CDC Multiple Cause of Death Database. Lancet 2021; 9 (01) 33-42
    PubMedGoogle Scholar
  • 21 Agnelli G, Buller HR, Cohen A. et al; AMPLIFY-EXT Investigators. Apixaban for extended treatment of venous thromboembolism. N Engl J Med 2013; 368 (08) 699-708
    CrossrefPubMedGoogle Scholar
  • 22 Weitz JI, Lensing AWA, Prins MH. et al; EINSTEIN CHOICE Investigators. Rivaroxaban or aspirin for extended treatment of venous thromboembolism. N Engl J Med 2017; 376 (13) 1211-1222
    CrossrefPubMedGoogle Scholar
  • 23 Albertsen IE, Piazza G, Goldhaber SZ. Let's stop dichotomizing venous thromboembolism as provoked or unprovoked. Circulation 2018; 138 (23) 2591-2593
    CrossrefPubMedGoogle Scholar
  • 24 Heit JA, Crusan DJ, Ashrani AA, Petterson TM, Bailey KR. Effect of a near-universal hospitalization-based prophylaxis regimen on annual number of venous thromboembolism events in the US. Blood 2017; 130 (02) 109-114
    CrossrefPubMedGoogle Scholar
  • 25 Pilny C. Top U.S. microcosm cities to test market a national product. 2014 ; Accessed December 4, 2020 at: https://smallbusiness.com/product-development/best-u-s-cities-to-test-market-a-national-product/
    PubMedGoogle Scholar
  • 26 Jim MA, Arias E, Seneca DS. et al. Racial misclassification of American Indians and Alaska Natives by Indian Health Service Contract Health Service Delivery Area. Am J Public Health 2014; 104 (Suppl. 03) S295-S302
    CrossrefPubMedGoogle Scholar
  • 27 Anderson RN, Copeland G, Hayes JM. Linkages to improve mortality data for American Indians and Alaska Natives: a new model for death reporting?. Am J Public Health 2014; 104 (Suppl. 03) S258-S262
    CrossrefPubMedGoogle Scholar
  • 28 Klinger EV, Carlini SV, Gonzalez I. et al. Accuracy of race, ethnicity, and language preference in an electronic health record. J Gen Intern Med 2015; 30 (06) 719-723
    CrossrefPubMedGoogle Scholar