Epidemiology of venous thromboembolism: implications for clinical practice.

Abstract

Venous thromboembolism (VTE), encompassing deep vein thrombosis (DVT) and pulmonary embolism (PE), is a common disorder with annual incident rates of 150 (95% confidence interval (CI) 131-169) / 100 000 (VTE), 90 (95% CI 72-109) / 100 000 (DVT) and 67 (95% CI 54-80) / 100 000 (PE), respectively in Western countries. Of note, reported VTE incidences are approximately 7-fold lower in East Asia. VTE incidence increases with age and is comparable between sexes, although men exhibit a higher risk of recurrence. Incidence rates of PE, but not of DVT, have been increasing in the last decades, reflecting changes in diagnostic workup and risk factors. VTE has a significant impact on mortality, and it is estimated that death from PE, which includes sudden death from undiagnosed, untreated PE may be responsible for approximately 3-4  of all deaths. But also diagnosed, treated VTE still carries a substantial risk with case fatality rates up to 10% in contemporary cohorts. Even when conservative calculations are applied, VTE deaths equal approximately 26 (95% CI 19-32) / 100 000 and rank-at least in Europe and North America-at the 3rd place for cardiovascular diseases and at the 5th place for death from all causes. In this article, we summarize the current state of knowledge and recent data on the epidemiology of VTE with a particular focus on mortality from PE and clinical implications.