Thromb Haemost 2007; 98(04): 756-764
DOI: 10.1160/TH07-03-0212
Blood Coagulation, Fibrinolysis and Cellular Haemostasis
Schattauer GmbH

Venous thromboembolism (VTE) in Europe

The number of VTE events and associated morbidity and mortality
Alexander T. Cohen
1   King’s College Hospital, London, UK
Giancarlo Agnelli
2   Division of Internal and Cardiovascular Medicine, University of Perugia, Perugia, Italy
Frederick A. Anderson
3   Center for Outcomes Research, University of Massachusetts Medical School, Worcester, MA, USA
Juan I. Arcelus
4   University of Granada Medical School and Hospital San Juan de Dios, Granada, Spain
David Bergqvist
5   Department of Surgical Sciences, University Hospital, Uppsala, Sweden
Josef G. Brecht
6   InForMed GmbH – Outcomes Research and Health Economics, Ingolstadt, Germany
Ian A. Greer
7   Department of Obstetrics and Gynaecology, University of Glasgow, Glasgow Royal Infirmary, Glasgow, UK
John A. Heit
8   Hematology Research, Mayo Clinic College of Medicine, Rochester, MN, USA
Julia L. Hutchinson
9   Fourth Hurdle Consulting, London, UK
Ajay K. Kakkar
10   Centre for Surgical Sciences, Barts and The London-Queen Mary School of Medicine, London, UK and Thrombosis Research Institute, London, UK
Dominique Mottier
11   Groupe d’Etude de la Thrombose de Bretagne Occidentale (GETBO), Hôpital de la Cavale Blanche, Brest, France
Emmanuel Oger
11   Groupe d’Etude de la Thrombose de Bretagne Occidentale (GETBO), Hôpital de la Cavale Blanche, Brest, France
Meyer-Michel Samama
12   Hôtel Dieu, Département d’Hématologie Biologique, Paris, France
Michael Spannagl
13   Ludwig-Maximillians University Munich, Klinikum der Universität, Abteilung Haemostasiologe, Munich, Germany
for the VTE Impact Assessment Group in Europe (VITAE) › Author Affiliations
Further Information

Publication History

Received 21 March 2007

Accepted after resubmission 25 July 2007

Publication Date:
01 December 2017 (online)


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 ofVTE 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 nonfatal 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 esti mated total number of symptomaticVTE 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 threequarters 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.