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Venous Thromboembolism According to Age
The Impact of an Aging Population
Paul D. Stein, MD;
Russell D. Hull, MBBS, MSc;
Fadi Kayali, MD;
William A. Ghali, MD, MPH;
Andrew K. Alshab, MD, MPH;
Ronald E. Olson, PhD
Arch Intern Med. 2004;164:2260-2265.
Background With the aging of the US population, there is concern that the rate of venous thromboembolism will increase, thereby increasing the health burden. In this study we sought to determine trends in the diagnosis of deep venous thrombosis (DVT) and pulmonary embolism (PE) in the elderly as well as the use of diagnostic tests.
Methods Data from the National Hospital Discharge Survey were used. These data are abstracted each year from a sample of records of patients discharged from non-federal short-stay hospitals in the entire United States. Main outcome measures were trends in rates of diagnosis of DVT and PE as well as trends in the use of diagnostic tests between 1979 and 1999.
Results The rates of diagnosis of DVT and PE and of the use of diagnostic tests over 21 years were markedly higher in elderly than in younger patients (P<.001). Although the rate of diagnosed DVT in elderly patients strikingly increased over the past decade (P< .001), that of PE has been relatively constant. There was a proportionately greater use of venous ultrasonography, ventilation-perfusion lung scanning, and pulmonary angiography in elderly than in younger patients.
Conclusions Extensive use of diagnostic tests in elderly patients in the past decade has resulted in an increased diagnostic rate for DVT but not PE. The reason for this disparity is uncertain but may reflect early diagnosis and treatment of DVT. With the aging of the population, DVT will increase the health burden.
Author Affiliations: Department of Research, St Joseph Mercy Oakland Hospital, Pontiac, Mich, (Drs Stein, Kayali, and Alshab) Department of Internal Medicine, Wayne State University, Detroit, Mich (Dr Stein); Departments of Medicine (Drs Hull and Ghali) and Community Health Services (Dr Ghali), University of Calgary, Calgary, Alberta; and Department of Grants, Contracts, and Sponsored Research, Oakland University, Rochester, Minn (Dr Olson).
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