title: Incidence of venous thromboembolism in a homebound population.
abstract: Venous thromboembolism (VTE) is a source of morbidity and mortality for high risk populations. The incidence of VTE has been characterized in many populations, but the incidence in homebound patients, a growing demographic, is unknown. The objective of this study was to estimate the incidence of VTE occurring at home in a cohort of patients enrolled in the Mount Sinai Visiting Doctor's Program (VDP), a home-based primary care program. The medical records of patients enrolled in the VDP over a 4 year period were examined. Incident VTE in a home setting was defined as the diagnosis of any symptomatic deep vein thrombosis or pulmonary embolism that did not occur during a hospitalization, within 4 weeks of a medical hospitalization, or within 12 weeks of a hospitalization for surgery. Functional status was abstracted for all patients, when available. Of 1,910 patients active during the study period, 39 cases of at-home VTE were identified (8.0 per 1,000 person years [95 % CI = 7.6-8.3]). Of these events, 30 of 39 were confirmed by radiological testing and considered definite, and 9 were considered probable. There was no statistically significant difference in age, race, or sex between the patients with and without VTE. In conclusion the estimated incidence of symptomatic VTE in a homebound population is low. There is insufficient evidence to support routine surveillance or prophylaxis strategies for VTE in homebound patients.
authors.affiliation: Department of Medical Education, Mount Sinai School of Medicine, New York, NY 10029, USA.
authors.forename: Jamal
authors.initials: J
authors.lastname: Ahmed
authors.forename: Katherine
authors.initials: K
authors.lastname: Ornstein
authors.forename: Andrew
authors.initials: A
authors.lastname: Dunn
authors.forename: Peter
authors.initials: P
authors.lastname: Gliatto
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D018577:Homebound Persons / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D008297:Male; D009519:New York City / Q000453:epidemiology; D054556:Venous Thromboembolism / Q000453:epidemiology*