Evidence Table 2Medical risk of VTE: incidence studies

PaperPopulationType of prophylaxisAsymptomatic DVTSymptomatic DVTPEFatal PENotes
Bosson et al., 200677

Country of study:
France

Study design:
prospective cohort

Recruitment period:
Oct 2002 – June 2003
Study setting:
General Practice, nationwide

Population:
Patients with an ‘acute medical event’ & reduced mobility managed in the community.

Inclusion criteria:
Outpatients aged at least 40yrs anticipated to have reduced mobility for at least 48h due to an acute medical event

Exclusion critieria:
Patients administered anticoagulants, reduced mobility before the start of the study due to surgery in the previous 6/52, bedridden for > 1month, incapable of complying with the protocol. 662 (3.9%) patients excluded due to administration of therapeutic or non- reported doses of anticoagulants, no follow-up visit, or occurrence of VTE at the or before the inclusion visit

(n= 16,532)
Risk factors
Male:female:
39.4%: 60.6%
Race: not specified
Age: 71 year
Initiated in 35% (n = 5782) patients: LMWH in 96.5% (n = 5582), UFH in 3.5% (n = 200). Median duration 10 (range 1–90) days. Results by ‘risk group’: in the major risk group incidence of DVT 2.5% (42/1664) in the treated patients compared with 1.2% (16/1318) in the non- treated pts. In the low risk group 1.4% (35/2499) vs 0.5% (35/6843)Not specified128 patients had DVT confirmed by duplex ultrasonography (note another 36 pts not confirmed on USS). Authors calculate incidence density for total of 164 patients as 0.50 (95% CI 0.42 –0.58) events/1000 patient days; incidence rate 1% (95% CI 0.84 – 1.14)27 patients had imaging confirmed PE. A total of 33 patients reported to have symptomatic PE. Based on 33 patients, authors report incidence density 0.1 events/1000 patient- days (95% CI 0.07 – 0.14). Incidence rate 0.2% (95% CI 0.13 – 0.27)8 fatal PE (none confirmed at autopsy)Duration of follow up:
Planned second visit at 3 weeks +/− 7 days. Duration of follow-up < 10 days in 98 pts (0.6%), 10–14days in 16 pts (0.1%) and between 14–28days in 16138 pts (99.3%)

Time to VTE:
Median time from inclusion to event 7 days (range 1–28 days) for DVT and 11 days (range 1–23 days) for PE

Notes:
Population: Severe acute infection 4727 (28.6%); acute rheumatism 4446 (26.9%); falls without # 2705 (16.4%); acute inflammatory episode 1934 (11.7%); decompensated cardiac insufficiency (NYHA III/IV) 825 (5%); decompensated respiratory insufficiency 752 (4.5%)

Limitations:
Patients managed in the community – ma not represent patients hospitalised with an acute medical illness.
Does not report baseline characteristics of the groups that did and did not receive prophylaxis.
Fatal PE not confirmed at autopsy and some cases of VTE did not have imaging confirmed diagnosis
Blom et al., 200467

Country of study:
Holland

Study design:
Retrospective cohort

Recruitment period:
1990–2000
Study setting:
Single centre hospital study

Population
Lung cancer patients

Inclusion criteria:
Patients identified from oncology database: first diagnosis of non- small cell lung cancer

Exclusion critieria:
57 medical records could not be traced, 50 patients not included as visited hospital only for laser therapy, 34 patients not included as they had a diagnosis of lung ca before 1990 or a primary diagnosis of lung ca could not be confirmed

(n=537)
Risk factors
Male:female: 429:108
Race: Not recorded
Age: Mean 65 years
Not recordedNot reported17 (3.2%)

Method of diagnosis not reported
22 (4.1%) (this includes DVT and PE)

Method of diagnosis not reported
Not analysedDuration of follow up:
Total 879 person-years of follow-up

Time to VTE:
Median time from first admittance for lung cancer until development of VTE = 5.3 months (range 0 – 56.5 months)

Notes:

Limitations:
Not necessarily in-hospital events. No description of other medical risk factors. ? Ongoing smoking.
Potential loss to follow-up and sudden death at home - fatal PE
Blom et al., 200668

Country of study:
Holland

Study design:
Retrospective cohort

Recruitment period:
1990–2000
Study setting:
Single centre hospital study

Population
pancreatic cancer patients

Inclusion criteria:
Patients identified from oncology database: all patients admitted with a tumour of the pancreas

Exclusion critieria:
27 patients excluded as only breifly visited for diagnosis or therapy; 7 patients excluded as they had a diagnosis of pancreatic cancer before 1990 or a primary diagnosis of pancreatic ca which could not be confirmed. 16 medical records could not be traced

(n=202)
Risk factors
Male:female: 115:87
Race: Not recorded
Age: Mean 64 years
Not recordedNot reported21 (10.4%)

Method of diagnosis not reported
6 (3.0%) (this includes DVT and PE)

Method of diagnosis not reported
Not analysedDuration of follow up:
Total 176 person years of follow-up

Time to VTE:
For patients with distant metastasis, median time for development of VTE 92 days. Data not supplied for patients without metastasis.

Notes:
Limitations:
Not necessarily in-hospital events.
No description of other medical risk factors.
Potential loss to follow-up and sudden death at home - fatal PE
Cook et al., 2005134

Country of study:
Canada

Study design:
Prospective cohort

Recruitment period:
Jan 2001–Jan 2002
Study setting:
Single university affiliated ICU

Population
Mixed critical care

Inclusion criteria:
≥ 18 years of age; anticipated to be in ICU for ≥ 72 hours

Exclusion critieria:
Admitting diagnosis of trauma; orthopaedic surgery; pregnancy; life support withdrawal

(n= 262)
Risk factors
Male:female:
59.8%:40.2%
Race:Not specified
Age: 66.9 (SD 15.1)
Routine medical-surgical ICU patients received UFH 2000 IU SC BD. Pts in whom heparin contraindicated recived pneumatic compression stockings. If contraindications to both, given antiembolic stocks. Ten patients (3.8%) had active bleeding and so were ineligible for anticoag prophylaxis. Of remaining 251, 233 (92.8%) received anticoagulants: 201 (81.7%) received UFH SC; 17 (6.8%) received UFH IV; 10 (4%) received LMWH; 1 (0.4%) received warfarinClinically unsuspected DVTs at ICU admission (prevalence): 4 patients. Clinically unsuspected DVTs occurring during ICU stay, identified by US (incidence): 22 patients

Bilateral lower extremity compression US within 48h of admission to ICU to determine DVT prevalence at admission. To determine incidence, bilateral lower extremity US twice weekly or if clinically suspected
Clinically suspected DVTs at ICU admission (prevalence): 3 patients. Clinically suspected DVTs occurring during ICU stay, identified by US (incidence): 3 patients3 patients with PE

Diagnosis with VQ/helical CT/pulmonary angiogram
Not specifiedDuration of follow up:
Up to hospital discharge. Median duration of hospital stay 25 days, IQR 13–52 days

Time to VTE:
DVTs which developed in ICU occurred at median ICU day 8, interquartile range 4 – 14)

Notes:
Risk factors:
Mean APACHE II score 25.5 (SD 8.4); BMI 27.1 (SD7.3); central venous catheter in 221 patients (84.7%).
Additional details provided re mechanical ventilation, admitting diagnosis, mortality etc but not broken down into VTE vs non-VTE grouping
Darze et al., 2005144

Country of study:
Brazil

Study design:
Prospective Cohort

Recruitment period:
July 2001 – March 2003
Study setting:
Coronary care unit of a tertiary care hospital

Population
Patients with congestive heart failure

Inclusion criteria:
Patients admitted to CCU with decompensated congestive heart failure F

Exclusion critieria:
Acute STEMI; admitting diagnosis other than congestive heart failure

(n=198)
Risk factors
Male:female: Not reported
Race: Not reported
Age: Not reported
Thromboprophylaxis was used by 12 of 18 patients (66.7%) with PE and 126 of 180 patients (70%) without PE (p = 0.77). All patients received enoxaparin, 40 mg qd, and none received unfractionated heparin or mechanical methods. There was no significant difference in the incidence of PE between patients who did or did not receive prophylaxis (8.7% vs 10%, p = 0.769)Not reportedNot reported18 (9.1%)

The diagnosis of PE was confirmed by high prob lung scintigraphy in 14 patients (78%) and positive spiral CT in 4 patients (22%)
Not analysedDuration of follow up:
Not reported

Time to VTE:
DVTs which developed in ICU occurred at median ICU day 8, interquartile range 4 – 14)

Notes:
Limitations:
No length of stay recorded. Not clear that these were incidence cases occurring on the unit compared with cases precipitating admissison
De Silva et al, 2006149

Country of study:
Singapore

Study design:
Prospective Cohort

Recruitment period:
June 2002 – December 2002
Study setting:
Single centre hospital

Population
Patients with ischaemic stroke

Inclusion criteria:
(1) acute ischemic stroke (diagnosed by a consultant neurologist based on clinical presentation and CT or MR brain imaging done within 48 h of symptom onset) and (2) a National Institute of Health Stroke Scale (NIHSS) score of >/= 1 for the lower limb affected by the acute stroke at time of recruitment screening which was carried out within 48 h of hospital admission

Exclusion critieria:
Past history of stroke or DVT

(n=105)
Risk factors
Male:female: 49: 62
Race: Chinese 92 (83%); Malay 9 (8%); Indian 9 (8%); Indian 9 (8%); Caucasian 1 (1%)
Age: Median 72 years
No patients on UFH or LMWH prior to first Doppler scan at day 7–10

All patients on anitplatelet therapy unless contraindicated - majority aspirin 100mg OD.
23 (22%) patients distal DVT, another 8 patients with proximal DVT (30%)

Doppler USS - routine at days 7–10 and 25–30 post stroke
None of the patients were symptomatic or had clinical signs on examination for DVT at the time of the first or second Doppler scans.1 (0.95%) diagnosed by spiral CTNoneDuration of follow up:
Functional assessment at 6 months.
Followed up re DVT for 25–30 days post stroke

Time to VTE:
Routine doppler scans at 7–10 days and 25–30 days post stroke

Notes:
Erelel et al., 2002173

Country of study:
Turkey

Study design:
Prospective Cohort

Recruitment period:
Not stated
Study setting:
Hospital setting

Population
Acute exacerbation COPD

Inclusion criteria:
One criterion for hospitalisation in an acute exacerbation COPD (as defined by American Thorax Society/European Resp Soc)

Exclusion critieria:
Clinical/radiological finding of lung ca; other haematological/solid malignancy; other systemic disease; other function limiting disease; other ‘risk grouping’ for DVT/PE

(n= 56)
Risk factors
Male:female: 46:10
Race: not reported
Age: not reported
Not reported4 (7.1%) on admission detected by colour doppler ultrasonography/venographyNot reported5 (9%) (of these: 3 PE + 2 PE w/DVT.
These DVTs are additional to those recorded previously) detected by V/Q scan
Not reportedDuration of follow up:
Not reported

Time to VTE:
Not reported

Notes:
Limitations:
This is only a point prevalence of DVT/PE at the point of admission to hospital with DVT. Does not analyse VTE over time while in hospital.
Problems - no analysis of population risk factors, confounding by prophylaxis?
Guijarro et al., 2005241

Country of study:
Spain

Study design:
Database review

Recruitment period:
1998–2001
Study setting:
32 hospitals in Spain

Population:
All hospital inpatients

Inclusion criteria:
Primary or secondary diagnosis with ICD-9- CM coding for embolism, pulmonary infarction, phlebitis, thrombophlebitis, thrombophlebitis/venous thrombosis in pregnancy and childbirth

Exclusion critieria:
Primary or secondary diagnosis with ICD-9- CM coding for Superficial phlebitis; thrombophlebitis of the upper limbs

(n=2,228,894)
Risk factors
Male:female: Not reported
Race: Not reported
Age: Not reported
No information providedNot analysed2162 with PE as secondary diagnosis at discharge (0.1%)5559 cases with DVT as the secondary diagnosis (0.25%)

Database coding used as confirmation of event
Not analysedDuration of follow up:
Not reported

Time to VTE:
Not reported

Notes:
Limitations:
Events were confirmed by coding, which is unreliable as secondary events may not always be reported appropriately.
This may explain why the DVT rate appears to be low.
There is no mention made of the prophylaxis strategy used in the patients.
Joynt et al., 2000320

Country of study:
Hong Kong

Study design:
Prospective cohort

Recruitment period:
January 1996 – Feburary 1998
Study setting:
Critical care unit

Population
Medical/surgical patients in critical care requiring a femoral line

Inclusion criteria:
Femoral line in mixed medical/surgical ICU

Exclusion critieria:
Infection/inflammation at insertion site, existing/previous DVT, recent pelvic/abdo trauma, lower extremity ischaemia, documented hypercoagulable state (protein C/S deficiency, antithrombin III deficiency, lupus anticoagulant), prior femoral catheterisation, survival < 24h post insertion of line

(n=124)
Risk factors
Male:female: Not reported
Race: Not reported
Age: Not reported
None12 (9.68%) ileofemoral DVT on side with femoral line; 2 (1.61%) ileofemoral on side without femoral line. Of the total of 14 DVTs, 2 were clinically obvious

Doppler USS - routine before insertion, within 12 hours after insertion, daily up to discharge, 24 hours after removal and at 1 week post removal
12 (9.68%) ileofemoral DVT on side with femoral line; 2 (1.61%) ileofemoral on side without femoral line. Of the total of 14 DVTs, 2 were clinically obviousNoneNoneDuration of follow up:
1 week after discharge from ICU

Time to VTE:
Not reported

Notes:
Kishimoto et al., 2005349

Country of study:
Japan

Study design:
Retrospective cohort

Recruitment period:
1987–1999
Study setting:
Single tertiary referral centre

Population
All hospital inpatients

Inclusion criteria:
None stated

Exclusion critieria:
None stated

(n=131,060)
Risk factors
Male:female:
46.3%:53.7%
Race: 99.5% Japanese
Age: Not stated
“There was no fixed policy for prophylaxis during the study period. Compression stockings rarely used, other forms (pneumatic compression devices, heparin, warfarin) were never used”Not analysed in this study128 patients were diagnosed with symptomatic DVT by venography or ultransound (0.1%)41 patients were diagnosed with symptomatic PE Pulmonary perfusion scintigraphy and/or contrast enhanced CT (0.03%)Not analysedDuration of follow up:
Hospital stay

Time to VTE:
44% of VTE diagnosed while an inpatient. Time from admission to diagnosis was mean 21.3 days +/− 21.2 S.D.

Notes:
Population:
The breakdown of the population included is not provided. Given that this population was admitted to a tertiary referral unit it is difficult to determine how representative the population is.

Limitations:
The VTE figures are divided up into those diagnosed on admission and those diagnosed as an inpatient, but these are not in turn broken down into DVT and PE.
Misra et al., 2005453

Country of study:
USA

Study design:
Retrospective cohort

Recruitment period:
July 2001 – July 2002
Study setting:
Mixed intensive care unit in a single hospital

Population
Medical, surgical, cardiac, transplant intensive care patients

Inclusion criteria:
Not stated

Exclusion critieria:
Not neurosurgery patients.

(n=4223)
Risk factors
Male:female:
49.1%: 50.9%
Race: not analysed
Age: 55.3 years
Not reportedNot analysed238 patients (5.62%)

Diagnosed with Doppler ultrasound when clinically indicated
45 patients (1.06%)

Diagnosed using Chest CT scan
Not reportedDuration of follow up:
Duration of ICU stay

Time to VTE:
Not reported

Notes:
Limitations:
No details of prophylaxis, no analysis of patient group/risk factors.
Not clear what the prevalence of DVT/PE was at the point of admission to ICU, vs how many acquired in the unit
Muscadere et al., 2007469

Country of study:
Canada

Study design:
Retrospective cohort

Recruitment period:
Jan 2001 – Feb 2002
Study setting:
Single centre intensive care unit

Population

Inclusion criteria:
ICU patients (medical, surgical and trauma) > 18 years with an ICU stay > 48 hours

Exclusion critieria:
Treatment for VTE diagnosed before the time of ICU admissions; therapeutic anticoagulation for other reasons during ICU stay

(n=600)
Risk factors
Male:female:
60.2%: 39.8
Race: Not analysed
Age: 59.5 years
Prophylaxis recorded for ICU stay and ward stay post-ICU: On ICU patients received prophylaxis for 87.6% (95% CI 81.5 – 93.7%) days in the unit. This was made up of 42.1% (39.8–45.4) low dose UFH; 11.2% (9.0–13.4%) LMWH; 34.3% (29.8–38.8) pneumatic compression stockings.
On the ward, prophylaxis for 59.8% days (55.1–65.7), made up of 41.9% (38.2–45.6) low dose UFH; 9.4% (6.7–12.1) LMWH; 3.5% (2.8–4.2) pneumatic compression stockings.
Not analysed in the study17 patients proximal DVT and an additional 19 patients proximal DVT & PE (recorded in PE box as well here) (6.0%)

Diagnosed by duplex ultrasonography
12 patients had proximal DVT and PE (also recorded in DVT box here) and an additional 13 patients had PE only (4.2%)

Diagnosed by CTPA/VQ scan/Pulmonary angiography
2 patients (0.3%) had fatal PE confirmed at autopsyDuration of follow up:
In hospital length of stay

Time to VTE:
Not analysed

Notes:
Note that 32 of 50 VTE events occurred after discharge from ICU to the ward. Prolonged duration of mechanical ventilation (8.8+/− 7.9 vs 6.4 +/− 6.4 days p = 0.05); prolonged ICU stay (14.8 vs 8.8 days, p <0.01) and prolonged duration of hospitalisation (47.5 +/−34.2 vs 23.6 +/− 20.8 days p < 0.001) associated with VTE. Rates of prophylaxis similar between group of patients receiving prophylaxis and those not
Oger et al., 2002501

Country of study:
France

Study design:
Prospective cohort

Recruitment period:
April 1999 – Jan 2000
Study setting:
Single centre, internal medical centre

Population
General medical patients

Inclusion criteria:
All patients admitted under internal medicine

Exclusion critieria:
Under 18 years of age; clinical suspicion of VTE; hospitalisation scheduled for < 4 days; patients referred from another hospital; any type of anticoagulant therpay for more than 48h prior to admissions; diseases requiring anticoagulants such as cardiac arrhythmias, ACS, or stroke; inability to give informed consent eg neuropsychiatric disorder

(n=234)
Risk factors
Male:female:
50.9%: 49.1%
Race: not analysed
Age: 66 years (SD = 16)
Unclear regarding whether prophylaxis was given.Prevalence of asymptomatic DVT at point of admission: 13 patients (5.5%, 95% CI 3.1–9.5). Incidence of asymptomatic DVT at day 5 and day 10 for patients negative on admission: 3/134 patients (day 5); 1/133 patients (day 10). Overall incidence of asymptomatic DVT during hospital follow- up was 2.6 per 1000 person-days (95% CI 0.0 to 5.2)

Diagnosed by compression ultrasonography
Not analysed in the studyNot analysedNot analysedDuration of follow up:
Median follow up 6 days

Time to VTE:
Not reported

Notes:
No information about provision of prophylaxis.
Patel et al, 2005512

Country of study:
Canada

Study design:
Retrospective cohort

Recruitment period:
Jan – Dec 2000
Study setting:
12 intensive care units

Population
Mixed medical and surgical patients admitted to intensive care unit.

Inclusion criteria:
ICU patients > 18 years

Exclusion critieria:
None stated

(n=12338)
Risk factors
Male:female: Not reported
Race: not reported
Age: Not reported
Prophylaxis only recorded for patients with VTE. Among pts with VTE, pharmacological or mechanical prophylaxis administered for 70.4% (95% CI 57.8–73.2%) of eligible ICU days. Details of drugs given or doses not recorded.TOTAL DVTs: 166 events, of which 44 were prevalent (present at/within 48h of admission) and 122 were incident cases after admission to ICU up to 8 weeks after discharge. 16.3% of DVTs were ‘clinically unsuspected’ and detected by screening. Authors report prevalent DVT in 0.4% (95%CI 0.3–0.5%) and incident DVT in 1.0% (95% CI 0.8–1.2%)

Screening by duplex ultrasonography or venography
See asymptomatic DVT boxTOTAL PEs: 111 events, of which 54 were prevalent and 57 were incident. 1.8% of PE events were clinically unsuspected. Authors report prevalent PE in 0.4% (95% CI 0.3–0.6%) and incident PE 0.5% (95% CI 0.4–0.6%)

VQ/CTPA/echocardi ocardiography/ECG/autopsy
Not reportedDuration of follow up:
In hospital length of stay up to a maximum of 8/52 post ICU discharge

Time to VTE:
Not analysed. “Most events occurred within 2 weeks of ICU admission”

Notes:
Population:

Limitations:
No analysis of the patients which did not have VTE
no analysis of classical risk factors; results not presented by prophylaxis; ECG and echo used for diagnosis of PE
Sachdev et al., 2006567

Country of study:
USA

Study design:
Prospective cohort

Recruitment period:
1997–2000
Study setting:
Mixed surgical/medical rehabilitation unit

Population
Rehabilitation - mixed medical/surgical

Inclusion criteria:
All patients admitted to rehabilitation programme

Exclusion critieria:
Pts receiving anticoagulation; patients with symptomatic or clinically suspected DVT

(n=380)
Risk factors
Male:female: 191:189
Race: not reported
Age: 64.7 yrs with DVT, 55.8 years without.
364 patients receiving prophylaxis at the point of first screening (admission to rehab programme) - either UFH or LMWHTotal DVT = 128 (34%) patients. In 25 patients (7%), DVT was found in both the thigh and calf veins; in 87 patients (23%), DVT was limited to the calf veins; and in 16 patients (4%), DVT was limited to the thigh veins

Duplex USS on admission to rehab programme. Follow-up USS achieved for 60 of the patients with positive initial scan within 6/52 of initial scan, after a mean of 13 days after first scan
Not reportedNot reportedNot reportedDuration of follow up:
Up to second ultrasound scan

Time to VTE:
Not reported

Notes:
Limitations: High loss to follow up
Skaf et al., 2005606

Country of study:
USA

Study design:
Database review

Recruitment period:
1979–2003
Study setting:
Multicentre study across hospitals in the USA

Population
Ischaemic or haemorrhagic stroke

Inclusion criteria:
NHDS codes for ischaemic stroke, DVT and PE

Exclusion critieria:
None reported

(n= Ischaemic = 14,109,000; haemorrhagic = 1,606,000)
Risk factors
Male:female: Not reported
Race: not reported
Age: not reported
Not analysed although the authors state: “we assume most patients with ischaemic stroke received antithrombotic therapyNot analysedIschaemic stroke:
104,000 (0.74%)

Haemorrhagic stroke:
22,000 (1.37%)

Method of diagnosis was not reported.
Ischaemic stroke:
72,000 (0.51%)

Haemorrhagic stroke:
11,000 (0.68%)

Method of diagnosis was not reported.
Not reportedDuration of follow up:
Until discharge (length of stay not analysed)

Time to VTE:
Not analysed

Notes:
Limitations: rates presented were from discharge coding and may not always have been accurate. Methods of diagnosis of DVT and PE were not reported
Stein et al., 1999624

Country of study:
USA

Study design:
Retrospective cohort

Recruitment period:
Jan 1993 – Sep 1997
Study setting:
All hospital inpatients

Population
Mixed medical and surgical patients

Inclusion criteria:
Discharge coding ICD-9- CM for PE and infarction; iatrogenic PE and infarction; PE (other); PE with abortion; PE with ectopic pregnancy, childbirth, in the puerperium

Exclusion critieria:
None stated

(n=175,730)
Risk factors
Male:female: Not reported
Race: not reported
Age: not reported
Not analysed. Hospital had no specific policy for prophylaxis during study period.Not analysed in this studyNot analysed in this study400 patients of 175,730, ie 0.23% (95% CI 0.21 to 0.25%). Incidence per year = 0.05%

Diagnosed by Positive VQ or pulmonary angiogram
Not analysed separatelyDuration of follow up:
In hospital stay. No information reported on length of stay

Time to VTE:
Not analysed

Notes:
Limitations:
No information on prophylaxis, no analysis of risk factors. Analysis of discharge coding does not restrict to in hospital VTE - may apply to patients who have VTE in the community and present to hospital
Stein et al., 2006623

Country of study:
USA

Study design:
Database revuew

Recruitment period:
1979–1999
Study setting:
Multicentre study across hospitals in the USA

Population
Mixed medical and surgical patients all with cancer.

Inclusion criteria:
NHDS codes for 19 malignancies, DVT and PE

Exclusion critieria:
None stated
(n=40,787,000)
Risk factors
Male:female: not reported
Race: not reported
Age: not reported
Not reportedNot reported643000 (1.6%) (1.6 DVT per 100 hospitalisations). This is the average rate for patients with cancer

Method of diagnosis was not reported.
245000 (0.6%) (0.6 per 100 hospitalisations). This is the average rate for patients with cancer

Method of diagnosis was not reported
Not reportedDuration of follow up:
Until discharge (length of stay not analysed)

Time to VTE:
Not reported

Notes:
Incidence for 19 different malignancies presented. Average rates recorded within the paper.

Limitations:
ncludes community DVT and PE of the patients who presented to hospital. Unclear whether the database review data includes information on patients who died
Information regarding surgery, metastasis, chemotherapy, radiotherapy, etc not available. No adjustment of cancer population re age/sex/medical comorbidities compared with the general hospital population for direct comparison

From: Appendix D, Evidence tables

Cover of Venous Thromboembolism
Venous Thromboembolism: Reducing the Risk of Venous Thromboembolism (Deep Vein Thrombosis and Pulmonary Embolism) in Patients Admitted to Hospital.
NICE Clinical Guidelines, No. 92.
National Clinical Guideline Centre – Acute and Chronic Conditions (UK).
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