title: Incidence of venous thromboembolism in nursing home residents.
abstract: OBJECTIVE
  Venous thromboembolism (VTE) is common in the elderly, but its epidemiology in nursing home residents remains unclear. This study estimated rates of VTE recorded on nursing home admission and incidence during residence.
  
  
  METHODS
  Retrospective analysis of AnalytiCare long term care (LTC) database for the period January 2007 to June 2009.
  
  
  METHODS
  181 nursing homes in 19 US states.
  
  
  METHODS
  Eligible residents had 1 or more admission Minimum Data Set (MDS) 2.0 assessment(s) over the study period. All VTE cases were extracted if MDS indicated deep vein thrombosis or pulmonary embolism. The number of admissions and days at risk were estimated from a random sample (n = 1350) of all residents.
  
  
  METHODS
  The earliest admission was identified as the admission index date. VTE cases were classified as either "On Admission" (VTE coded on admission index date) or "During Residence" (coded afterward). Residents were followed from admission index date until censoring.
  
  
  RESULTS
  A total of 2144 VTE admission cases (3.7% of all admissions) were identified. A further 757 cases of VTE occurring during residence were identified, yielding an incidence of 3.68 cases of VTE per 100 person-years of postadmission residence. VTE admission rates were highest for residents younger than 50 years (4.8%, confidence interval [CI]: 3.9%-5.9%) and 50 to 64 years (5.1%, CI: 4.6%-5.7%) but similar for those aged 65 to 74 (3.6%, CI: 3.3%-4.0%), 75 to 84 (3.6%, CI: 3.3%-3.9%), and 85 years or older (3.1%, CI: 2.9%-3.4%). The incidence of VTE during residence was similar among these age strata.
  
  
  CONCLUSIONS
  Approximately 1 in 25 nursing home admissions had a VTE diagnosis. VTE incidence during residence was higher than reported in earlier nursing home studies. These incidence rates merit further investigation because diagnostic improvements may be driving greater recognition of VTE in LTC.
authors.affiliation: Informagenics, LLC and The Ohio State University College of Pharmacy, Columbus, OH, USA. greardon@informagenics.com
authors.forename: Gregory
authors.initials: G
authors.lastname: Reardon
authors.forename: Naushira
authors.initials: N
authors.lastname: Pandya
authors.forename: Edith A
authors.initials: EA
authors.lastname: Nutescu
authors.forename: Joyce
authors.initials: J
authors.lastname: Lamori
authors.forename: C V
authors.initials: CV
authors.lastname: Damaraju
authors.forename: Jeff
authors.initials: J
authors.lastname: Schein
authors.forename: Brahim
authors.initials: B
authors.lastname: Bookhart
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D005260:Female; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008134:Long-Term Care; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009735:Nursing Homes; D011655:Pulmonary Embolism / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D054556:Venous Thromboembolism / Q000453:epidemiology* / Q000517:prevention & control; D020246:Venous Thrombosis / Q000453:epidemiology
keywords: Venous thromboembolism; deep vein thrombosis; incidence; nursing home; pulmonary embolism