%0 Journal Article %J Am J Med %D 2004 %T Deep vein thrombosis and pulmonary embolism in two cohorts: the longitudinal investigation of thromboembolism etiology. %A Cushman, Mary %A Tsai, Albert W %A White, Richard H %A Heckbert, Susan R %A Rosamond, Wayne D %A Enright, Paul %A Folsom, Aaron R %K Aged %K Case-Control Studies %K Cohort Studies %K Female %K Follow-Up Studies %K Humans %K Incidence %K Male %K Middle Aged %K Neoplasms %K Population Surveillance %K Pulmonary Embolism %K Recurrence %K Risk Factors %K Survival Rate %K Venous Thrombosis %X

PURPOSE: To determine the incidence of deep vein thrombosis and pulmonary embolism in two cohorts representing regions of the United States.

METHODS: The sample comprised 21,680 participants of the Atherosclerosis Risk in Communities study and the Cardiovascular Health Study. Subjects were aged >/=45 years, resided in six communities, and were followed for 7.6 years. All hospitalizations were identified and thromboses were validated by chart review.

RESULTS: The age-standardized incidence of first-time venous thromboembolism was 1.92 per 1000 person-years. Rates were higher in men than women, and increased with age in both sexes. There was no antecedent trauma, surgery, immobilization, or diagnosis of cancer for 48% (175/366) of events. The 28-day case-fatality rate was 11% (29/265) after a first venous thromboembolism and 25% (17/67) for cancer-associated thrombosis. The recurrence rate 2 years after a first venous thromboembolism was 7.7% per year (95% confidence interval [CI]: 4.5% to 10.9% per year). Cancer was the only factor independently associated with 28-day fatality (relative risk [RR] = 5.2; 95% CI: 1.4 to 19.9) or recurrent thrombosis (RR = 9.2; 95% CI: 2.0 to 41.7).

CONCLUSION: The incidence of venous thromboembolism in this cohort of middle- and older-aged subjects was similar to that observed in more geographically homogeneous samples. Half of cases were idiopathic. Short-term mortality and 2-year recurrence rates were appreciable, especially among subjects with cancer. Based on this study we estimate that 187,000 cases of first-time venous thromboembolism are diagnosed yearly in the United States among those aged 45 years or older.

%B Am J Med %V 117 %P 19-25 %8 2004 Jul 01 %G eng %N 1 %1 https://www.ncbi.nlm.nih.gov/pubmed/15210384?dopt=Abstract %R 10.1016/j.amjmed.2004.01.018