Estimated annual numbers of US acute-care hospital patients at risk for venous thromboembolism

被引:221
作者
Anderson, Frederick A., Jr.
Zayaruzny, Maxim
Helt, John A.
Fidan, Dogan
Cohen, Alexander T.
机构
[1] Univ Massachusetts, Med Ctr, Sch Outcomes Res, Ctr Outcomes Res, Worcester, MA 01605 USA
[2] Mayo Clin, Coll Med, Rochester, MN USA
[3] Sanofi Aventis, Paris 2, France
[4] Kings Coll Hosp London, London, England
关键词
D O I
10.1002/ajh.20983
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Venous thromboembolism (VTE) is a major US health problem. However, the total number of US inpatients who are at risk for VTE is unknown. Our objective was to estimate the number of US acute-care hospital inpatients who were at risk for VTE according to criteria established by the Seventh American College of Chest Physicians (ACCP) Consensus Conference on Antithrombotic and Thrombolytic Therapy guidelines for VTE prevention. Using the 2003 Nationwide Inpatient Sample from the Healthcare Cost and Utilization Project (HCUP), patient diagnoses and procedures were examined to identify major surgery patients (age >= 18 years, length of hospital stay >= 2 days) and medical patients (age >= 40 years, length of hospital stay >= 2 days). ACCP guidelines were used to estimate the number of surgical and medical patients at risk of developing VTE. Of an estimated 38,220,659 discharges in 2003, 7,786,390 (20%) were surgical inpatients; 44% of which were at low risk for VTE, while 15%, 24%, and 17% were at moderate, high, and very high risk for VTE, respectively. Of the remaining 15,161,586 medical patients, 7,742,419 (51%) met ACCP VTE risk criteria. Over 12 million patients, comprising 31% of US hospital discharges in 2003, were at risk of VTE. Given the existence of internationally-accepted evidence-based guidelines for prevention of VTE, research is required to establish if this patient population is receiving recommended VTE prophylaxis.
引用
收藏
页码:777 / 782
页数:6
相关论文
共 25 条
[1]  
Ageno W, 2002, HAEMATOLOGICA, V87, P746
[2]   Fatal pulmonary embolism in hospitalised patients: a necropsy review [J].
Alikhan, R ;
Peters, F ;
Wilmott, R ;
Cohen, AT .
JOURNAL OF CLINICAL PATHOLOGY, 2004, 57 (12) :1254-1257
[3]   Missed opportunities for prevention of venous thromboembolism - An evaluation of the use of thromboprophylaxis guidelines [J].
Arnold, DA ;
Kahn, SR ;
Shrier, I .
CHEST, 2001, 120 (06) :1964-1971
[4]   Economic burden of long-term complications of deep vein thrombosis after total hip replacement surgery in the United States [J].
Caprini, JA ;
Botteman, MF ;
Stephens, JM ;
Nadipelli, V ;
Ewing, MM ;
Brandt, S ;
Pashos, CL ;
Cohen, AT .
VALUE IN HEALTH, 2003, 6 (01) :59-74
[5]   PREVENTION OF VENOUS THROMBOEMBOLISM [J].
CLAGETT, GP ;
ANDERSON, FA ;
LEVINE, MN ;
SALZMAN, EW ;
WHEELER, HB .
CHEST, 1992, 102 (04) :S391-S407
[6]   Prevention of venous thromboembolism [J].
Geerts, WH ;
Pineo, GF ;
Heit, JA ;
Bergqvist, D ;
Lassen, MR ;
Colwell, CW ;
Ray, JG .
CHEST, 2004, 126 (03) :338S-400S
[7]   A prospective registry of 5,451 patients with ultrasound-confirmed deep vein thrombosis [J].
Goldhaber, SZ ;
Tapson, VF .
AMERICAN JOURNAL OF CARDIOLOGY, 2004, 93 (02) :259-262
[8]   Risk factors for deep vein thrombosis and pulmonary embolism -: A population-based case-control study [J].
Heit, JA ;
Silverstein, MD ;
Mohr, DN ;
Petterson, TM ;
O'Fallon, WM ;
Melton, LJ .
ARCHIVES OF INTERNAL MEDICINE, 2000, 160 (06) :809-815
[9]   Predictors of survival after deep vein thrombosis and pulmonary embolism - A population-based, cohort study [J].
Heit, JA ;
Silverstein, MD ;
Mohr, DN ;
Petterson, TM ;
O'Fallon, WM ;
Melton, LJ .
ARCHIVES OF INTERNAL MEDICINE, 1999, 159 (05) :445-453
[10]   Relative impact of risk factors for deep vein thrombosis and pulmonary embolism - A population-based study [J].
Heit, JA ;
O'Fallon, WM ;
Petterson, TM ;
Lohse, CM ;
Silverstein, MD ;
Mohr, DN ;
Melton, LJ .
ARCHIVES OF INTERNAL MEDICINE, 2002, 162 (11) :1245-1248