Incidence rate of symptomatic venous thromboembolic disease in patients from a medical care program in Buenos Aires, Arg
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ORIGINAL CLINICAL INVESTIGATION
Open Access
Incidence rate of symptomatic venous thromboembolic disease in patients from a medical care program in Buenos Aires, Argentina: a prospective cohort Fernando Javier Vázquez1*, María Lourdes Posadas-Martínez2, Jimena Vicens2,3, Fernán González Bernaldo de Quirós2 and Diego Hernán Giunta2
Abstract Background: The incidence of venous thromboembolic disease (VTED) is estimated to be, on average, 1–2 cases per 1,000 individuals per year worldwide. There are few data concerning the incidence rate (IR) of VTED in the Argentinean population at large. Our aim was to estimate the IR of VTED at the Italian Hospital Medical Care Program (IHMCP) in Buenos Aires, the most populous city in Argentina. Methods: This prospective cohort study evaluated all consecutive incident cases of pulmonary thromboembolism (PTE) and deep vein thrombosis (DVT) confirmed in patients over the age of 17 who were members of the IHMCP from June 2006 to May 2012. Any patient who had an initial confirmed VTED episode and was a member of the IHMCP at the time of diagnosis was considered an incident case. Results: There were 1,138 cases of VTED for 687,871 person-years of follow-up. The crude IR of VTED was 1.65 (95% CI: 1.56 to 1.75) per 1,000 person-years. The highest IR was found in subjects >80 years old (5.92 per 1,000 person years; 95% CI: 5.41 to 6.49). The IRs adjusted to the population of the city of Buenos Aires were 0.90 (95% CI: 0.84 to 0.95) for VTED, 0.71 (95% CI: 0.66 to 0.76) for DVT, and 0.34 (95% CI: 0.31 to 0.37) for PTE. Conclusions: VTED is a common health problem with a high IR in members of the IHMCP, especially the elderly. This is the first paper to report prospectively the cumulative incidence of VTED in Latin America. Keywords: Epidemiology, Incidence, Pulmonary embolism, Venous thromboembolism, Venous thrombosis
Background Venous thromboembolic disease (VTED) is the most common preventable cause of death among hospital patients [1]. While VTED can affect patients of any age, it is reported that its frequency increases in older individuals [2]. The most common manifestations of VTED include pulmonary thromboembolism (PTE) and deep vein thrombosis (DVT) of the lower limbs [1,3-6]. * Correspondence: [email protected] 1 Departamento de Medicina Interna [Internal Medicine Department], 2° piso [2nd floor], Hospital Italiano de Buenos Aires [Italian Hospital of Buenos Aires], Perón 4190, Buenos Aires C1181ACH, Argentina Full list of author information is available at the end of the article
Presentation signs and symptoms of VTED are unspecific and, when untreated, may lead to fatal PTE [7], pulmonary hypertension, and postphlebitic syndrome. [1,3-6,8,9]. The most common risk factors for the development of VTED are neoplasms, recent surgery, and hospitalisation for medical reasons [10-12]. The incidence rate for the initial episode of VTED is between 0.71 and 1.17 cases per 1,000 persons of the Caucasian population [2,13-19]. The incidence variability depends on the
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