Skip to main content
Top
Published in: Thrombosis Journal 1/2013

Open Access 01-12-2013 | Original clinical investigation

Incidence rate of symptomatic venous thromboembolic disease in patients from a medical care program in Buenos Aires, Argentina: a prospective cohort

Authors: Fernando Javier Vázquez, María Lourdes Posadas-Martínez, Jimena Vicens, Fernán González Bernaldo de Quirós, Diego Hernán Giunta

Published in: Thrombosis Journal | Issue 1/2013

Login to get access

Abstract

Background

The incidence of venous thromboembolic disease (VTED) is estimated to be, on average, 1–2 cases per 1,000 individuals per year worldwide. There are few data concerning the incidence rate (IR) of VTED in the Argentinean population at large.
Our aim was to estimate the IR of VTED at the Italian Hospital Medical Care Program (IHMCP) in Buenos Aires, the most populous city in Argentina.

Methods

This prospective cohort study evaluated all consecutive incident cases of pulmonary thromboembolism (PTE) and deep vein thrombosis (DVT) confirmed in patients over the age of 17 who were members of the IHMCP from June 2006 to May 2012. Any patient who had an initial confirmed VTED episode and was a member of the IHMCP at the time of diagnosis was considered an incident case.

Results

There were 1,138 cases of VTED for 687,871 person-years of follow-up. The crude IR of VTED was 1.65 (95% CI: 1.56 to 1.75) per 1,000 person-years. The highest IR was found in subjects >80 years old (5.92 per 1,000 person years; 95% CI: 5.41 to 6.49).
The IRs adjusted to the population of the city of Buenos Aires were 0.90 (95% CI: 0.84 to 0.95) for VTED, 0.71 (95% CI: 0.66 to 0.76) for DVT, and 0.34 (95% CI: 0.31 to 0.37) for PTE.

Conclusions

VTED is a common health problem with a high IR in members of the IHMCP, especially the elderly. This is the first paper to report prospectively the cumulative incidence of VTED in Latin America.
Appendix
Available only for authorised users
Literature
1.
go back to reference Geerts WH, Bergqvist D, Pineo GF, Heit JA, Samama CM, Lassen MR, Colwell CW: Prevention of venous thromboembolism: american college of chest physicians evidence-based clinical practice guidelines (8th edition). Chest 2008, 133: 381S-453S. 10.1378/chest.08-0656CrossRefPubMed Geerts WH, Bergqvist D, Pineo GF, Heit JA, Samama CM, Lassen MR, Colwell CW: Prevention of venous thromboembolism: american college of chest physicians evidence-based clinical practice guidelines (8th edition). Chest 2008, 133: 381S-453S. 10.1378/chest.08-0656CrossRefPubMed
2.
go back to reference Silverstein MD, Heit JA, Mohr DN, Petterson TM, O’Fallon WM, Melton LJ 3rd: Trends in the incidence of deep vein thrombosis and pulmonary embolism: a 25-year population-based study. Arch Intern Med 1998, 158: 585-593. 10.1001/archinte.158.6.585CrossRefPubMed Silverstein MD, Heit JA, Mohr DN, Petterson TM, O’Fallon WM, Melton LJ 3rd: Trends in the incidence of deep vein thrombosis and pulmonary embolism: a 25-year population-based study. Arch Intern Med 1998, 158: 585-593. 10.1001/archinte.158.6.585CrossRefPubMed
3.
go back to reference Dentali F, Ageno W, Becattini C, Galli L, Gianni M, Riva N, Imberti D, Squizzato A, Venco A, Agnelli G: Prevalence and clinical history of incidental, asymptomatic pulmonary embolism: a meta-analysis. Thromb Res 2010, 125: 518-522. 10.1016/j.thromres.2010.03.016CrossRefPubMed Dentali F, Ageno W, Becattini C, Galli L, Gianni M, Riva N, Imberti D, Squizzato A, Venco A, Agnelli G: Prevalence and clinical history of incidental, asymptomatic pulmonary embolism: a meta-analysis. Thromb Res 2010, 125: 518-522. 10.1016/j.thromres.2010.03.016CrossRefPubMed
4.
go back to reference Fedullo PF, Tapson VF: Clinical practice. the evaluation of suspected pulmonary embolism. N Engl J Med 2003, 349: 1247-1256. 10.1056/NEJMcp035442CrossRefPubMed Fedullo PF, Tapson VF: Clinical practice. the evaluation of suspected pulmonary embolism. N Engl J Med 2003, 349: 1247-1256. 10.1056/NEJMcp035442CrossRefPubMed
5.
go back to reference Girard P, Sanchez O, Leroyer C, Musset D, Meyer G, Stern JB, Parent F: Deep venous thrombosis in patients with acute pulmonary embolism: prevalence, risk factors, and clinical significance. Chest 2005, 128: 1593-1600. 10.1378/chest.128.3.1593CrossRefPubMed Girard P, Sanchez O, Leroyer C, Musset D, Meyer G, Stern JB, Parent F: Deep venous thrombosis in patients with acute pulmonary embolism: prevalence, risk factors, and clinical significance. Chest 2005, 128: 1593-1600. 10.1378/chest.128.3.1593CrossRefPubMed
6.
go back to reference Guyatt GH, Akl EA, Crowther M, Schunemann HJ, Gutterman DD, Zelman Lewis S: Introduction to the ninth edition: antithrombotic therapy and prevention of thrombosis, 9th ed: american college of chest physicians evidence-based clinical practice guidelines. Chest 2012, 141: 48S-52S. 10.1378/chest.11-2286PubMedCentralCrossRefPubMed Guyatt GH, Akl EA, Crowther M, Schunemann HJ, Gutterman DD, Zelman Lewis S: Introduction to the ninth edition: antithrombotic therapy and prevention of thrombosis, 9th ed: american college of chest physicians evidence-based clinical practice guidelines. Chest 2012, 141: 48S-52S. 10.1378/chest.11-2286PubMedCentralCrossRefPubMed
7.
go back to reference Engelberger RP, Aujesky D, Calanca L, Staeger P, Hugli O, Mazzolai L: Comparison of the diagnostic performance of the original and modified wells score in inpatients and outpatients with suspected deep vein thrombosis. Thromb Res 2011, 127: 535-539. 10.1016/j.thromres.2011.02.008CrossRefPubMed Engelberger RP, Aujesky D, Calanca L, Staeger P, Hugli O, Mazzolai L: Comparison of the diagnostic performance of the original and modified wells score in inpatients and outpatients with suspected deep vein thrombosis. Thromb Res 2011, 127: 535-539. 10.1016/j.thromres.2011.02.008CrossRefPubMed
8.
go back to reference Kahn SR, Ginsberg JS: Relationship between deep venous thrombosis and the postthrombotic syndrome. Arch Intern Med 2004, 164: 17-26. 10.1001/archinte.164.1.17CrossRefPubMed Kahn SR, Ginsberg JS: Relationship between deep venous thrombosis and the postthrombotic syndrome. Arch Intern Med 2004, 164: 17-26. 10.1001/archinte.164.1.17CrossRefPubMed
9.
go back to reference Pengo V, Lensing AW, Prins MH, Marchiori A, Davidson BL, Tiozzo F, Albanese P, Biasiolo A, Pegoraro C, Iliceto S, Prandoni P: Incidence of chronic thromboembolic pulmonary hypertension after pulmonary embolism. N Engl J Med 2004, 350: 2257-2264. 10.1056/NEJMoa032274CrossRefPubMed Pengo V, Lensing AW, Prins MH, Marchiori A, Davidson BL, Tiozzo F, Albanese P, Biasiolo A, Pegoraro C, Iliceto S, Prandoni P: Incidence of chronic thromboembolic pulmonary hypertension after pulmonary embolism. N Engl J Med 2004, 350: 2257-2264. 10.1056/NEJMoa032274CrossRefPubMed
10.
go back to reference Kahn SR, Lim W, Dunn AS, Cushman M, Dentali F, Akl EA, Cook DJ, Balekian AA, Klein RC, Le H, et al.: Prevention of VTE in nonsurgical patients: antithrombotic therapy and prevention of thrombosis, 9th ed: american college of chest physicians evidence-based clinical practice guidelines. Chest 2012, 141: e195S-e226S. 10.1378/chest.11-2296PubMedCentralCrossRefPubMed Kahn SR, Lim W, Dunn AS, Cushman M, Dentali F, Akl EA, Cook DJ, Balekian AA, Klein RC, Le H, et al.: Prevention of VTE in nonsurgical patients: antithrombotic therapy and prevention of thrombosis, 9th ed: american college of chest physicians evidence-based clinical practice guidelines. Chest 2012, 141: e195S-e226S. 10.1378/chest.11-2296PubMedCentralCrossRefPubMed
11.
go back to reference Falck-Ytter Y, Francis CW, Johanson NA, Curley C, Dahl OE, Schulman S, Ortel TL, Pauker SG, Colwell CW Jr: Prevention of VTE in orthopedic surgery patients: antithrombotic therapy and prevention of thrombosis, 9th ed: american college of chest physicians evidence-based clinical practice guidelines. Chest 2012, 141: e278S-e325S. 10.1378/chest.11-2404PubMedCentralCrossRefPubMed Falck-Ytter Y, Francis CW, Johanson NA, Curley C, Dahl OE, Schulman S, Ortel TL, Pauker SG, Colwell CW Jr: Prevention of VTE in orthopedic surgery patients: antithrombotic therapy and prevention of thrombosis, 9th ed: american college of chest physicians evidence-based clinical practice guidelines. Chest 2012, 141: e278S-e325S. 10.1378/chest.11-2404PubMedCentralCrossRefPubMed
12.
go back to reference Gould MK, Garcia DA, Wren SM, Karanicolas PJ, Arcelus JI, Heit JA, Samama CM: Prevention of VTE in nonorthopedic surgical patients: antithrombotic therapy and prevention of thrombosis, 9th ed: american college of chest physicians evidence-based clinical practice guidelines. Chest 2012, 141: e227S-e277S. 10.1378/chest.11-2297PubMedCentralCrossRefPubMed Gould MK, Garcia DA, Wren SM, Karanicolas PJ, Arcelus JI, Heit JA, Samama CM: Prevention of VTE in nonorthopedic surgical patients: antithrombotic therapy and prevention of thrombosis, 9th ed: american college of chest physicians evidence-based clinical practice guidelines. Chest 2012, 141: e227S-e277S. 10.1378/chest.11-2297PubMedCentralCrossRefPubMed
13.
go back to reference Anderson FA Jr, Wheeler HB, Goldberg RJ, Hosmer DW, Patwardhan NA, Jovanovic B, Forcier A, Dalen JE: 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: 933-938. 10.1001/archinte.1991.00400050081016CrossRefPubMed Anderson FA Jr, Wheeler HB, Goldberg RJ, Hosmer DW, Patwardhan NA, Jovanovic B, Forcier A, Dalen JE: 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: 933-938. 10.1001/archinte.1991.00400050081016CrossRefPubMed
14.
go back to reference Cohen AT, Agnelli G, Anderson FA, Arcelus JI, Bergqvist D, Brecht JG, Greer IA, Heit JA, Hutchinson JL, Kakkar AK, et al.: Venous thromboembolism (VTE) in europe. the number of VTE events and associated morbidity and mortality. Thromb Haemost 2007, 98: 756-764.PubMed Cohen AT, Agnelli G, Anderson FA, Arcelus JI, Bergqvist D, Brecht JG, Greer IA, Heit JA, Hutchinson JL, Kakkar AK, et al.: Venous thromboembolism (VTE) in europe. the number of VTE events and associated morbidity and mortality. Thromb Haemost 2007, 98: 756-764.PubMed
15.
go back to reference Fowkes FJ, Price JF, Fowkes FG: Incidence of diagnosed deep vein thrombosis in the general population: systematic review. Eur J Vasc Endovasc Surg 2003, 25: 1-5. 10.1053/ejvs.2002.1778CrossRefPubMed Fowkes FJ, Price JF, Fowkes FG: Incidence of diagnosed deep vein thrombosis in the general population: systematic review. Eur J Vasc Endovasc Surg 2003, 25: 1-5. 10.1053/ejvs.2002.1778CrossRefPubMed
16.
go back to reference Heit JA, Melton LJ 3rd, Lohse CM, Petterson TM, Silverstein MD, Mohr DN, O’Fallon WM: Incidence of venous thromboembolism in hospitalized patients vs community residents. Mayo Clin Proc 2001, 76: 1102-1110. 10.4065/76.11.1102CrossRefPubMed Heit JA, Melton LJ 3rd, Lohse CM, Petterson TM, Silverstein MD, Mohr DN, O’Fallon WM: Incidence of venous thromboembolism in hospitalized patients vs community residents. Mayo Clin Proc 2001, 76: 1102-1110. 10.4065/76.11.1102CrossRefPubMed
17.
go back to reference Klatsky AL, Armstrong MA, Poggi J: Risk of pulmonary embolism and/or deep venous thrombosis in Asian-Americans. Am J Cardiol 2000, 85: 1334-1337. 10.1016/S0002-9149(00)00766-9CrossRefPubMed Klatsky AL, Armstrong MA, Poggi J: Risk of pulmonary embolism and/or deep venous thrombosis in Asian-Americans. Am J Cardiol 2000, 85: 1334-1337. 10.1016/S0002-9149(00)00766-9CrossRefPubMed
18.
go back to reference Oger E: Incidence of venous thromboembolism: a community-based study in Western France. EPI-GETBP study group. Groupe d’Etude de la Thrombose de Bretagne Occidentale. Thromb Haemost 2000, 83: 657-660.PubMed Oger E: Incidence of venous thromboembolism: a community-based study in Western France. EPI-GETBP study group. Groupe d’Etude de la Thrombose de Bretagne Occidentale. Thromb Haemost 2000, 83: 657-660.PubMed
20.
go back to reference Mazzei JA, Campos AL, Melero MJ: [Frequency and incidence of venous thromboembolism in a general hospital]. Medicina (B Aires) 2005, 65: 289-294. Mazzei JA, Campos AL, Melero MJ: [Frequency and incidence of venous thromboembolism in a general hospital]. Medicina (B Aires) 2005, 65: 289-294.
21.
go back to reference De Castro-Silva M: Venous thromboembolism in the State of Minas Gerais and its projection to Brazil: study based in 2,331,353 hospitalisations. Int Angiol 1997, 16: 193-196.PubMed De Castro-Silva M: Venous thromboembolism in the State of Minas Gerais and its projection to Brazil: study based in 2,331,353 hospitalisations. Int Angiol 1997, 16: 193-196.PubMed
25.
go back to reference Value of the ventilation/perfusion scan in acute pulmonary embolism: Results of the prospective investigation of pulmonary embolism diagnosis (PIOPED). the PIOPED investigators. JAMA 1990, 263: 2753-2759.CrossRef Value of the ventilation/perfusion scan in acute pulmonary embolism: Results of the prospective investigation of pulmonary embolism diagnosis (PIOPED). the PIOPED investigators. JAMA 1990, 263: 2753-2759.CrossRef
26.
go back to reference Kearon C, Hirsh J: The diagnosis of pulmonary embolism. Haemostasis 1995, 25: 72-87.PubMed Kearon C, Hirsh J: The diagnosis of pulmonary embolism. Haemostasis 1995, 25: 72-87.PubMed
27.
go back to reference Kearon C, Julian JA, Newman TE, Ginsberg JS: Noninvasive diagnosis of deep venous thrombosis. McMaster diagnostic imaging practice guidelines initiative. Ann Intern Med 1998, 128: 663-677. 10.7326/0003-4819-128-8-199804150-00011CrossRefPubMed Kearon C, Julian JA, Newman TE, Ginsberg JS: Noninvasive diagnosis of deep venous thrombosis. McMaster diagnostic imaging practice guidelines initiative. Ann Intern Med 1998, 128: 663-677. 10.7326/0003-4819-128-8-199804150-00011CrossRefPubMed
28.
go back to reference Perrier A, Roy PM, Sanchez O, Le Gal G, Meyer G, Gourdier AL, Furber A, Revel MP, Howarth N, Davido A, Bounameaux H: Multidetector-row computed tomography in suspected pulmonary embolism. N Engl J Med 2005, 352: 1760-1768. 10.1056/NEJMoa042905CrossRefPubMed Perrier A, Roy PM, Sanchez O, Le Gal G, Meyer G, Gourdier AL, Furber A, Revel MP, Howarth N, Davido A, Bounameaux H: Multidetector-row computed tomography in suspected pulmonary embolism. N Engl J Med 2005, 352: 1760-1768. 10.1056/NEJMoa042905CrossRefPubMed
29.
go back to reference Cogo A, Lensing AW, Wells P, Prandoni P, Buller HR: Noninvasive objective tests for the diagnosis of clinically suspected deep-vein thrombosis. Haemostasis 1995, 25: 27-39.PubMed Cogo A, Lensing AW, Wells P, Prandoni P, Buller HR: Noninvasive objective tests for the diagnosis of clinically suspected deep-vein thrombosis. Haemostasis 1995, 25: 27-39.PubMed
30.
go back to reference Fraser JD, Anderson DR: Deep venous thrombosis: recent advances and optimal investigation with US. Radiology 1999, 211: 9-24.CrossRefPubMed Fraser JD, Anderson DR: Deep venous thrombosis: recent advances and optimal investigation with US. Radiology 1999, 211: 9-24.CrossRefPubMed
31.
go back to reference Ahmad O, Boschi-Pinto C, Lopez A, Murray C, Lozano R, Inoue M: Age standarization on rates: a new WHO standard 2001. In Book Age standarization on rates: a new WHO standard 2001 (Editor ed.^eds.). City: WHO; 2001. Ahmad O, Boschi-Pinto C, Lopez A, Murray C, Lozano R, Inoue M: Age standarization on rates: a new WHO standard 2001. In Book Age standarization on rates: a new WHO standard 2001 (Editor ed.^eds.). City: WHO; 2001.
32.
go back to reference Rosner B: Fundamentals of Biostatistics 7th edn. Boston, MA: Broocks/Cole; 2011. Rosner B: Fundamentals of Biostatistics 7th edn. Boston, MA: Broocks/Cole; 2011.
33.
go back to reference Hansson PO, Welin L, Tibblin G, Eriksson H: Deep vein thrombosis and pulmonary embolism in the general population. ‘the study of men born in 1913’. Arch Intern Med 1997, 157: 1665-1670. 10.1001/archinte.1997.00440360079008CrossRefPubMed Hansson PO, Welin L, Tibblin G, Eriksson H: Deep vein thrombosis and pulmonary embolism in the general population. ‘the study of men born in 1913’. Arch Intern Med 1997, 157: 1665-1670. 10.1001/archinte.1997.00440360079008CrossRefPubMed
Metadata
Title
Incidence rate of symptomatic venous thromboembolic disease in patients from a medical care program in Buenos Aires, Argentina: a prospective cohort
Authors
Fernando Javier Vázquez
María Lourdes Posadas-Martínez
Jimena Vicens
Fernán González Bernaldo de Quirós
Diego Hernán Giunta
Publication date
01-12-2013
Publisher
BioMed Central
Published in
Thrombosis Journal / Issue 1/2013
Electronic ISSN: 1477-9560
DOI
https://doi.org/10.1186/1477-9560-11-16

Other articles of this Issue 1/2013

Thrombosis Journal 1/2013 Go to the issue