The changing pattern of venous thromboembolic disease.
A review of 14,667 necropsy reports for every year from 1965 to 1990 and 6,436 diagnostic venograms performed from 1976 to 1990 was undertaken at a single teaching hospital. A progressive reduction in the percentage of necropsies reporting fatal pulmonary embolism from 6.1 to 2.1%, occurred over the 25-year period (chi(2) tests for linear trend with time p < 0.00001). Over the last decade, there has been a significant reduction in the rate of venographically diagnosed postoperative deep vein thrombosis (DVT) from 49.9 to 24.7 per 100,000 population (p < 0.0001) which was in marked contrast to the constant rate of non-postoperative DVT. Our findings suggest that the introduction of thromboprophylactic measures, in addition to changes in hospital practice, may have had a highly significant effect on the pattern of this serious, but potentially avoidable disease.
Cohen
A T
AT
Thrombosis Research Institute, Chelsea, UK.
Edmondson
R A
RA
Phillips
M J
MJ
Ward
V P
VP
Kakkar
V V
VV
D000925:Anticoagulants / Q000627:therapeutic use; D001344:Autopsy; D004363:Drug Utilization / Q000706:statistics & numerical data; D004739:England / Q000453:epidemiology; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006801:Humans; D015994:Incidence; D009026:Mortality / Q000639:trends; D010690:Phlebography; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000401:mortality / Q000517:prevention & control; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging / Q000401:mortality* / Q000517:prevention & control; D012189:Retrospective Studies; D015912:Thrombolytic Therapy / Q000706:statistics & numerical data; D013924:Thrombophlebitis / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000517:prevention & control
D000925:Anticoagulants; D005343:Fibrinolytic Agents