Clinical burden of venous thromboembolism

Background: Venous thromboembolism (VTE), which includes deep vein thrombosis and pulmonary embolism (PE), is a major cause of morbidity and mortality. VTE is a common disorder, with an estimated annual incidence of approximately 5-12 persons per 10,000. The prognosis for patients who develop VTE is exacerbated by the risk of recurrent VTE, post-thrombotic syndrome and chronic pulmonary hypertension as a long-term complication of PE. Scope: To assess the clinical burden of VTE a literature search was carried out to identify references published between 1997 and 2008 using Medline, the Cochrane Library and the Health Economic Evaluations Database. Findings: VTE is a frequent clinical problem, both in the general population, in hospitalised patients and in particular in patients undergoing major orthopaedic surgery, after trauma, or those with malignancy, and related complications are frequent. VTE imposes significant consequences on patients and on the healthcare systems that support them - extending hospital stays and precipitating additional hospitalisations. Limitations of the review are that the sources quoted may not adequately reflect all publications and all perspectives on the topic. Conclusions: Even among high-risk groups it is not possible to identify individuals who will go on to develop VTE, and, therefore, thromboprophylaxis is a recommended component of the management of high-risk patients. Ensuring patients receive safe, effective, easily administered antithrombotic therapy both in hospital and post-discharge, for a sufficient length of time, should be central to any strategy to reduce incident or recurrent VTE and minimise the risk of long-term complications.