Trends in the Incidence of Deep Vein Thrombosis and Pulmonary Embolism

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Abstract
THE REPORTED annual incidence of venous thromboembolism varies widely, ranging from 43.7 to 145.0 per 100000 (published rates were age- and sex-adjusted to the 1980 US white population) for deep vein thrombosis and 20.8 to 65.8 per 100000 for pulmonary embolism.1-5 A number of study design factors may have contributed to the wide variation in reported rates. For example, different studies identified cases using data from a variety of sources, including patient questionnaires,1 the US National Hospital Discharge Survey,2 or Medicare claims.6 Because of diagnostic uncertainty or misclassification, data from these sources may have underestimated or overestimated the actual incidence rate. Moreover, none of these studies accurately separated initial from recurrent events or included events discovered during autopsy. Studies that identified cases solely by review of inpatient medical records may have underestimated the true incidence since cases not occurring in an acute-care hospital (eg, cases from nursing homes or other long-term care facilities and those in which death occurred suddenly within the community) could be missed.3 Some studies report data from only selected populations, such as patients aged 65 years or older,6 patients referred to tertiary care centers for diagnostic evaluation and treatment,4 or patients from different geographic districts.5 Furthermore, there are no studies of trends in the incidence of venous thromboembolism over time. Due to these limitations in existing data, we performed a study to estimate the incidence of deep vein thrombosis and pulmonary embolism within a well-defined geographic population and describe trends in incidence over time.