Seasonal variation in the frequency of venous thromboembolism: An updated result of a meta-analysis and systemic review

2020 ◽  
Vol 35 (7) ◽  
pp. 480-494 ◽  
Author(s):  
Haibin Zhao ◽  
Yeni Li ◽  
Manli Wu ◽  
Weidong Ren ◽  
Chao Ji ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Deep Vein Thrombosis ◽  
Seasonal Variation ◽  
Venous Thromboembolism ◽  
Lower Incidence ◽  
Meta Analysis ◽  
Systemic Review ◽  
Low Latitude ◽  
Vein Thrombosis ◽  
Deep Vein

Objective Venous thromboembolism, including deep vein thrombosis and pulmonary embolism, is likely to cause the death of both medical and surgical patients. Despite some evidence of seasonal variation in the incidence of venous thromboembolism, the existing studies obtain contradictory results. A temporal pattern for pulmonary embolism is known, but data on deep vein thrombosis are inconclusive. The purpose of this study is to make a meta-analysis and systematically review the literature about seasonal variations of pulmonary embolism and/or deep vein thrombosis in order to objectively diagnose venous thromboembolism. Methods According to dichotomous data, risk ratios (RRs) and 95% confidence intervals (CIs) were used to compare the incidence of venous thromboembolism in different seasons. The research was classified according to pulmonary embolism mortality, pulmonary embolism/deep vein thrombosis incidence, latitude/elevation/climatic types, and monthly incidence for four subgroup comparisons. There were a total of 23 eligible studies, in which 40,309 patients with venous thromboembolism were compared. Results The pooled total venous thromboembolism incidence was 27.2% in winter, 23.1% in spring, 24.6% in summer, and 25.1% in autumn. According to the results of pooled analysis, the incidence of venous thromboembolism in winter was much higher than that in summer (RR = 1.12, 95% CI: 1.01–1.24, adjusted P = .04), especially deep vein thrombosis. Moreover, the incidence of venous thromboembolism in summer and autumn was lower than that in winter in low-latitude (<200 m) areas and median low-latitude (0–50°-N) areas. Interestingly, the frequency of pulmonary embolism mortality was the largest in spring and smallest in summer (spring > winter ≈ autumn > summer). For monthly data, a statistically significantly lower incidence of venous thromboembolism was observed in May and July than in October. Conclusions The study revealed a significantly higher incidence of venous thromboembolism and deep vein thrombosis in winter than in summer. Pulmonary embolism mortality occurred more frequently in spring than during other seasons. A statistically significantly lower incidence of venous thromboembolism was observed in May and July compared with that in October.

scholarly journals Proximal Deep Vein Thrombosis and Pulmonary Embolism in COVID-19 Patients: A Systematic Review and Meta-Analysis Short Tittle: Venous Thromboembolism in COVID-19 Patients

2020 ◽  
Author(s):  
Gregoire Longchamp ◽  
Sara Manzocchi-Besson ◽  
Alban Longchamp ◽  
Marc Righini ◽  
Helia Robert-Ebadi ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Deep Vein Thrombosis ◽  
Venous Thromboembolism ◽  
Meta Analysis ◽  
Proximal Deep Vein Thrombosis ◽  
Primary Analysis ◽  
Thrombotic Risk ◽  
Medically Ill ◽  
Vein Thrombosis ◽  
Deep Vein

Abstract BACKGROUNGCOVID-19 appears to be associated with a high risk of venous thromboembolism (VTE). We aimed to systematically review and meta-analyze the risk of clinically relevant VTE in patients hospitalized for COVID-19. METHODSThis meta-analysis included original articles in English published from 01/01/2020 to 06/15/2020 in Pubmed/MEDLINE, Embase, Web of science, and Cochrane. Outcomes were major VTE, defined as any objectively diagnosed pulmonary embolism (PE) and/or proximal deep vein thrombosis (DVT). Primary analysis estimated the risk of VTE, stratified by acutely and critically ill inpatients. Secondary analyses explored the separate risk of proximal DVT and of PE; the risk of major VTE stratified by screening and by type of anticoagulation. RESULTSIn 33 studies (n=4’009 inpatients) with heterogeneous thrombotic risk factors, VTE incidence was 9% (95%CI 5-13%, I2=92.5) overall, and 21% (95%CI 14-28%, I2=87.6%) for patients hospitalized in the ICU. Proximal lower limb DVT incidence was 3% (95%CI 1-5%, I2= 87.0%) and 8% (95%CI 3-14%, I2=87.6%), respectively. PE incidence was 8% (95%CI 4-13%, I2=92.1%) and 17% (95%CI 11-25%, I2=89.3%), respectively. Screening and absence of anticoagulation were associated with a higher VTE incidence. When restricting to medically ill inpatients, the VTE incidence was 2% (95%CI 0-6%).CONCLUSIONSThe risk of major VTE among COVID-19 inpatients is high but varies greatly with severity of the disease. These findings reinforce the need for the use of thromboprophylaxis in all COVID-19 inpatients and for clinical trials testing different thromboprophylaxis regimens in subgroups of COVID-19 inpatients. TRIAL REGISTRATIONThe review protocol was registered in PROSPERO International Prospective Register of Systematic Reviews (CRD42020193369).

Incidence of venous thromboembolism among patients receiving neoadjuvant chemotherapy for advanced epithelial ovarian cancer

2020 ◽  
Vol 30 (4) ◽  
pp. 491-497 ◽  
Author(s):  
Julia Rose Salinaro ◽  
Kourtnie McQuillen ◽  
Megan Stemple ◽  
Robert Boccaccio ◽  
Jessie Ehrisman ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Pulmonary Embolism ◽  
Deep Vein Thrombosis ◽  
Venous Thromboembolism ◽  
Adjuvant Chemotherapy ◽  
Neoadjuvant Chemotherapy ◽  
Epithelial Ovarian Cancer ◽  
Primary Outcome ◽  
Vein Thrombosis ◽  
Deep Vein

ObjectivesNeoadjuvant chemotherapy may be considered for women with epithelial ovarian cancer who have poor performance status or a disease burden not amenable to primary cytoreductive surgery. Overlap exists between indications for neoadjuvant chemotherapy and known risk factors for venous thromboembolism, including impaired mobility, increasing age, and advanced malignancy. The objective of this study was to determine the rate of venous thromboembolism among women receiving neoadjuvant chemotherapy for epithelial ovarian cancer.MethodsA multi-institutional, observational study of patients receiving neoadjuvant chemotherapy for primary epithelial ovarian, fallopian tube, or peritoneal cancer was conducted. Primary outcome was rate of venous thromboembolism during neoadjuvant chemotherapy. Secondary outcomes included rates of venous thromboembolism at other stages of treatment (diagnosis, following interval debulking surgery, during adjuvant chemotherapy, or during treatment for recurrence) and associations between occurrence of venous thromboembolism during neoadjuvant chemotherapy, subject characteristics, and interval debulking outcomes. Venous thromboembolism was defined as deep vein thrombosis in the upper or lower extremities or in association with peripherally inserted central catheters or ports, pulmonary embolism, or concurrent deep vein thrombosis and pulmonary embolism. Both symptomatic and asymptomatic venous thromboembolism were reported.ResultsA total of 230 patients receiving neoadjuvant chemotherapy were included; 63 (27%) patients overall experienced a venous thromboembolism. The primary outcome of venous thromboembolism during neoadjuvant chemotherapy occurred in 16 (7.7%) patients. Of the remaining venous thromboembolism events, 22 were at diagnosis (9.6%), six post-operatively (3%), five during adjuvant chemotherapy (3%), and 14 during treatment for recurrence (12%). Patients experiencing a venous thromboembolism during neoadjuvant chemotherapy had a longer mean time to interval debulking and were less likely to undergo optimal cytoreduction (50% vs 80.2%, p=0.02).ConclusionsPatients with advanced ovarian cancer are at high risk for venous thromboembolism while receiving neoadjuvant chemotherapy. Consideration of thromboprophylaxis may be warranted.

Venous Thromboembolism

2017 ◽  
Author(s):  
Guillermo A. Escobar ◽  
Peter K. Henke ◽  
Thomas W. Wakefield
Keyword(s):  
Pulmonary Embolism ◽  
Deep Vein Thrombosis ◽  
Venous Thromboembolism ◽  
Lower Extremity ◽  
The United States ◽  
Laboratory Evaluation ◽  
Individual Risk ◽  
Vein Thrombosis ◽  
Clinical Scenarios ◽  
Deep Vein

Deep vein thrombosis (DVT) and pulmonary embolism (PE) comprise venous thromboembolism (VTE). Together, they comprise a serious health problem as there are over 275,000 new VTE cases per year in the United States, resulting in a prevalence of one to two per 1,000 individuals, with some studies suggesting that the incidence may even be double that. This review covers assessment of a VTE event, initial evaluation of a patient suspected of having VTE, medical history, clinical presentation of VTE, physical examination, laboratory evaluation, imaging, prophylaxis against perioperative VTE, indications for immediate intervention (threat to life or limb), indications for urgent intervention, and management of nonemergent VTE. Figures show a modified Caprini score questionnaire used at the University of Michigan to determine individual risk of VTE and the indicated prophylaxis regimen; Wells criteria for DVT and PE; phlegmasia cerulea dolens secondary to acute left iliofemoral DVT after thigh trauma; compression duplex ultrasonography of lower extremity veins; computed tomographic angiogram of the chest demonstrating a thrombus in the pulmonary artery, with extension into the right main pulmonary; management of PE according to Wells criteria findings; management of PE with right heart strain in cases of massive or submassive PE; treatment of DVT according to clinical scenario; a lower extremity venogram of a patient with May-Thurner syndrome and its subsequent endovascular treatment; and various examples of retrievable vena cava filters (not drawn to scale). Tables list initial clinical assessment for VTE, clinical scenarios possibly benefiting from prolonged anticoagulation after VTE, indications for laboratory investigation of secondary thrombophilia, venous thromboembolic risk accorded to hypercoagulable states, and Pulmonary Embolism Rule-out Criteria Score to avoid the need for D-dimer in patients suspected of having PE.   This review contains 11 highly rendered figures, 5 tables, and 167 references. Key words: anticoagulation; deep vein thrombosis; postthrombotic syndrome; pulmonary embolism; recurrent venous thromboembolism; thrombophilia; venous thromboembolism; PE; VTE; DVT 

scholarly journals Venous Thromboembolism in Denmark: Seasonality in Occurrence and Mortality

TH Open ◽  
2019 ◽  
Vol 03 (02) ◽  
pp. e171-e179 ◽  
Author(s):  
Nils Skajaa ◽  
Erzsébet Horváth-Puhó ◽  
Kasper Adelborg ◽  
Paolo Prandoni ◽  
Kenneth J. Rothman ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Deep Vein Thrombosis ◽  
Venous Thromboembolism ◽  
Seasonal Pattern ◽  
Cerebral Vein ◽  
Cerebral Vein Thrombosis ◽  
Splanchnic Vein Thrombosis ◽  
Vein Thrombosis ◽  
Winter Peak ◽  
Deep Vein

Background Many cardiovascular conditions exhibit seasonality in occurrence and mortality, but little is known about the seasonality of venous thromboembolism. Methods Using Danish registries, we identified all patients with deep vein thrombosis, pulmonary embolism, splanchnic vein thrombosis, cerebral vein thrombosis, and retinal vein thrombosis during 1977–2016. We tallied monthly deaths occurring within 90 days of the venous thromboembolism diagnosis. We estimated peak-to-trough ratios and timing of the peak of both diagnoses and deaths summed over all years of the study period. The departure from 1.0 of the peak-to-trough ratio measures the intensity of any seasonal pattern. Results We estimated a peak-to-trough ratio of 1.09 (95% confidence interval: 1.07–1.11) for deep vein thrombosis and 1.22 (1.19–1.24) for pulmonary embolism occurrence. The peak-to-trough ratios for splanchnic vein thrombosis, cerebral vein thrombosis, and retinal vein thrombosis occurrence were 1.10 (1.01–1.20), 1.19 (1.00–1.40), and 1.12 (1.07–1.17), respectively. The occurrence of all conditions peaked during winter or fall. In time trend analyses, the peak-to-trough ratio increased considerably for splanchnic vein thrombosis, cerebral vein thrombosis, and retinal vein thrombosis occurrence. In associated mortality, the peak-to-trough ratio for deep vein thrombosis was larger (1.15, 1.07–1.23) than that for pulmonary embolism (1.04, 1.01–1.08). Discussion Excess winter risks were modest, but more marked for pulmonary embolism occurrence than for deep vein thrombosis occurrence. The seasonal pattern intensified throughout the study period for splanchnic vein thrombosis, cerebral vein thrombosis, and retinal vein thrombosis. The winter peak in mortality following pulmonary embolism was smaller than that for deep vein thrombosis.

Risk of recurrent venous thromboembolism among deep vein thrombosis and pulmonary embolism patients treated with warfarin

2014 ◽  
Vol 31 (3) ◽  
pp. 439-447 ◽  
Author(s):  
Beth L. Nordstrom ◽  
Michael A. Evans ◽  
Brian R. Murphy ◽  
Edith A. Nutescu ◽  
Jeff R. Schein ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Deep Vein Thrombosis ◽  
Venous Thromboembolism ◽  
Vein Thrombosis ◽  
Recurrent Venous Thromboembolism ◽  
Deep Vein

More than one in two venous thromboembolism treated in French hospitals occurs during the hospital stays

2015 ◽  
Vol 31 (6) ◽  
pp. 390-396 ◽  
Author(s):  
Francois-André Allaert ◽  
Eric Benzenine ◽  
Catherine Quantin
Keyword(s):  
Pulmonary Embolism ◽  
Deep Vein Thrombosis ◽  
Venous Thromboembolism ◽  
Hospital Stay ◽  
Principal Diagnosis ◽  
Vein Thrombosis ◽  
Icd 10 ◽  
Hospital Stays ◽  
Deep Vein

Objective The objective was to describe the prevalence of venous thromboembolism, pulmonary embolism, and deep vein thrombosis among hospitalized patients and the percentages of those occurring during the hospital stays. Methods French DRG gave now the opportunity to investigate the frequency of venous thromboembolism occurring during the hospital stay. Statistics are issued from the national PMSI MCO databases encoded using the CIM10. Since 2010–2011 it is possible to differentiate the reason for hospital admission from the pathologies which secondly occurred. Any stay with the ICD-10 codes selected was considered as a hospital-occurred thrombosis unless it was the principal diagnosis of the first medical unit summary. To eliminate outpatient consultations or in day care, stays of <48 h were excluded. Results The results pertain to the 78,838,983 hospitalizations in France from 2005 to 2011 and on the 18,683,603 hospital stays in 2010–2011. The incidence of hospital stays came to 860,343 (1.09%) for venous thromboembolism, with 428,261 (0.543%) for deep vein thrombosis without pulmonary embolism and 432,082 (0.548%) for pulmonary embolism. It corresponds to an incidence of 189 per 100,000 inhabitants. Out of 100 hospital stays involving venous thromboembolism, for 40.3% venous thromboembolism was the cause of hospitalization whereas 59.7% can be considered to have occurred during hospital stay. These distributions are of 25.6 and 74.4% for deep vein thrombosis, respectively, 53.8 and 46.2% for pulmonary embolism. Conclusion The high proportion of hospital-occurred venous thromboembolism is an alarming situation that should question the quality of prevention and/or its effectiveness.

Late consequences of venous thromboembolism: Measuring quality of life after deep vein thrombosis and pulmonary embolism

2018 ◽  
Vol 164 ◽  
pp. 170-176 ◽  
Author(s):  
Waleed Ghanima ◽  
Hilde Skuterud Wik ◽  
Mazdak Tavoly ◽  
Tone Enden ◽  
Lars-Petter Jelsness-Jørgensen
Keyword(s):  
Quality Of Life ◽  
Pulmonary Embolism ◽  
Deep Vein Thrombosis ◽  
Venous Thromboembolism ◽  
Vein Thrombosis ◽  
Deep Vein

Comparison of clinical probability-adjusted D-dimer and age-adjusted D-dimer interpretation to exclude venous thromboembolism

2017 ◽  
Vol 117 (10) ◽  
pp. 1937-1943 ◽  
Author(s):  
Jim Julian ◽  
Lori-Ann Linkins ◽  
Shannon Bates ◽  
Clive Kearon ◽  
Sarah Takach Lapner
Keyword(s):  
Pulmonary Embolism ◽  
Deep Vein Thrombosis ◽  
Venous Thromboembolism ◽  
Diagnostic Accuracy ◽  
Blood Samples ◽  
Vein Thrombosis ◽  
Clinical Probability ◽  
Deep Vein ◽  
New Strategies ◽  
D Dimer

SummaryTwo new strategies for interpreting D-dimer results have been proposed: i) using a progressively higher D-dimer threshold with increasing age (age-adjusted strategy) and ii) using a D-dimer threshold in patients with low clinical probability that is twice the threshold used in patients with moderate clinical probability (clinical probability-adjusted strategy). Our objective was to compare the diagnostic accuracy of age-adjusted and clinical probability-adjusted D-dimer interpretation in patients with a low or moderate clinical probability of venous thromboembolism (VTE). We performed a retrospective analysis of clinical data and blood samples from two prospective studies. We compared the negative predictive value (NPV) for VTE, and the proportion of patients with a negative D-dimer result, using two D-dimer interpretation strategies: the age-adjusted strategy, which uses a progressively higher D-dimer threshold with increasing age over 50 years (age in years × 10 µg/L FEU); and the clinical probability-adjusted strategy which uses a D-dimer threshold of 1000 µg/L FEU in patients with low clinical probability and 500 µg/L FEU in patients with moderate clinical probability. A total of 1649 outpatients with low or moderate clinical probability for a first suspected deep vein thrombosis or pulmonary embolism were included. The NPV of both the clinical probability-adjusted strategy (99.7%) and the age-adjusted strategy (99.6%) were similar. However, the proportion of patients with a negative result was greater with the clinical probability-adjusted strategy (56.1% vs, 50.9%; difference 5.2%; 95% CI 3.5% to 6.8%). These findings suggest that clinical probability-adjusted D-dimer interpretation is a better way of interpreting D-dimer results compared to age-adjusted interpretation.

Sign in / Sign up

Export Citation Format

Share Document