Venous thromboembolism (VTE) in Europe

Alexander T. Cohen; Giancarlo Agnelli; Frederick A. Anderson; Juan I. Arcelus; David Bergqvist; Josef G. Brecht; Ian A. Greer; John A. Heit; Julia L. Hutchinson; Ajay K. Kakkar; Dominique Mottier; Emmanuel Oger; Meyer-Michel Samama; Michael Spannagl; for the VTE Impact Assessment Group in Europe (VITAE)

doi:10.1160/TH07-03-0212

Thrombosis and Haemostasis, Inhaltsverzeichnis

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

Authors

Alexander T. Cohen

¹King’s College Hospital, London, UK
Giancarlo Agnelli

²Division of Internal and Cardiovascular Medicine, University of Perugia, Perugia, Italy
Frederick A. Anderson

³Center for Outcomes Research, University of Massachusetts Medical School, Worcester, MA, USA
Juan I. Arcelus

⁴University of Granada Medical School and Hospital San Juan de Dios, Granada, Spain
David Bergqvist

⁵Department of Surgical Sciences, University Hospital, Uppsala, Sweden
Josef G. Brecht

⁶InForMed GmbH – Outcomes Research and Health Economics, Ingolstadt, Germany
Ian A. Greer

⁷Department of Obstetrics and Gynaecology, University of Glasgow, Glasgow Royal Infirmary, Glasgow, UK
John A. Heit

⁸Hematology Research, Mayo Clinic College of Medicine, Rochester, MN, USA
Julia L. Hutchinson

⁹Fourth Hurdle Consulting, London, UK
Ajay K. Kakkar

¹⁰Centre for Surgical Sciences, Barts and The London-Queen Mary School of Medicine, London, UK and Thrombosis Research Institute, London, UK
Dominique Mottier

¹¹Groupe d’Etude de la Thrombose de Bretagne Occidentale (GETBO), Hôpital de la Cavale Blanche, Brest, France
Emmanuel Oger

¹¹Groupe d’Etude de la Thrombose de Bretagne Occidentale (GETBO), Hôpital de la Cavale Blanche, Brest, France
Meyer-Michel Samama

¹²Hôtel Dieu, Département d’Hématologie Biologique, Paris, France
Michael Spannagl

¹³Ludwig-Maximillians University Munich, Klinikum der Universität, Abteilung Haemostasiologe, Munich, Germany

for the VTE Impact Assessment Group in Europe (VITAE)

Abstract

Summary

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.

Keywords

Deep-vein thrombosis - post-thrombotic syndrome - pulmonary embolism - pulmonary hypertension - venous thromboembolism - VTE prophylaxis

Volltext

Referenzen

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