PREVALENCE OF ACUTE VENOUS THROMBOEMBOLISM IN PATIENTS ADMITTED WITH HEART FAILURE IN THE UNITED STATES: ANALYSIS FROM NATIONAL INPATIENT SAMPLE 2004-2013
Venous thromboembolism (VTE) is the third most common cause of cardiovascular death after stroke and heart attack. It affects over 350,000 people and is responsible for more than 100,000 deaths each year. Heart failure (HF) has been identified as a major risk factor for VTE. Patients with HF are prone to thrombophlebitis of pelvic or leg veins which predispose them to deep vein thrombosis/pulmonary embolism (DVT/PE). Thus, exploring trend of VTE in HF patients in recent 10 years will help in understanding the balance between effectiveness of VTE prophylaxis and technologies for detection of VTE which have become routine.
We utilized the National Inpatient Sample database from 2004 - 2013 to find association between hospitalized heart failure (HF) patients with DVT, PE and VTE. We selected non-pregnant patients over the age of 18 admitted with HF in US hospitals over the specified period. We chose diagnoses of HF, DVT, PE and VTE based on International Classification of disease-9 (ICD-9) and Clinical Classification Software-Diagnoses codes. We used STATA version 13.0 (College Station, TX) to calculate and MS-Excel 2016 and Joinpoint Regression Program version 126.96.36.199 to plot yearly trend of association and mortality in hospitalized patients with HF and DVT, PE or VTE.
We found an overall increasing trend in prevalence of DVT, PE and VTE in hospitalized patients with HF. In contrast, we found an overall decreasing trend in mortality in hospitalized patients with HF in association with DVT, PE or VTE.
The increase in diagnosis of VTE closely parallels increases seen nationwide over the past decade. Interestingly, other others have similarly described the nearly universal adoption of DVT prophylaxis with either unchanged or slightly increased VTE risk. Identification of more patients with lower risk thromboses, possibly due to the extreme increase availability and use of imaging, may explain the increase in diagnosis with a concomitant decrease in mortality in the same population.
Journal of the American College of Cardiology
Basnet, S., Dhital, R., Poudel, D., & Donato, A. A. (2017). PREVALENCE OF ACUTE VENOUS THROMBOEMBOLISM IN PATIENTS ADMITTED WITH HEART FAILURE IN THE UNITED STATES: ANALYSIS FROM NATIONAL INPATIENT SAMPLE 2004-2013. Journal of the American College of Cardiology, 71 (11 Supplement) https://doi.org/10.1016/S0735-1097(18)31448-7