engleski

Non-inherited causes of newly diagnosed venous thromboembolism in Croatia in 2011 – Croatian Cooperative Group for Hematologic Diseases (CROHEM) study

Background: Venous thromboembolism (VTE) is a major medical health problem associated with significant morbidity and mortality. VTE is a multifactorial disease, resulting from a complex interaction of genetic and acquired factors. The incidence and characteristics of VTE in Croatia has not been well described. Aims: To investigate non inherited causes of VTE among newly diagnosed patients with secondary VTE in Croatia. Methods: Croatian Cooperative Group for Hematologic Diseases (CROHEM) conducted observational non interventional epidemiological study from January 1st until December 31st 2011 analyzing medical records of newly diagnosed patients with VTE from 5 major general hospitals (Sibenik, Knin, Koprivnica, Slavonski Brod, and Varazdin) in 4 different Croatian counties (Sibenin-Knin County, Koprivnica-Krizevci County, Brod-Posavina County, and Varazdin County). Study was approved by a medical ethics committee of each hospital. Methods: There were 642 new cases of VTE in 2011 ; 389 (60.59%) of them with deep vein thrombosis (DVT), 218 (33.96%) with pulmonary embolism (PE), and 35 (5.45%) cases of both conditions. There were 280 (43.6%) males (median age 65 years) and 362 (56.4%) females (median age 74 years, P < 0.001 compared to male). Among them, 371 (57.8%) were secondary and 271 (42.2%) were idiopathic VTE. Recidivism of VTE was diagnosed in 78 patients (12.15%). There was no difference in recidivism between secondary and idiopathic VTE. Although patient population with VTE was in general old (median age 71 years), patients with secondary VTE were younger than those with idiopathic VTE (median age 69 vs. 74 years, P < 0.001). There was no gender difference between them. The most frequent causes of secondary VTE were cancer (40.4% of secondary VTE) and trauma, surgery and immobilization (37.5% of secondary VTE), while other causes of secondary VTE were less frequent (other diseases (e.g. neurological diseases with paralysis, autoimmune diseases, inflammatory bowel diseases) (17.9%), sepsis (9.7%), central venous catheter (3.25%), pregnancy [2.16% of secondary VTE]). More than one non inherited risk factor for VTE had 43.40% of patients with secondary VTE. Among all 642 VTE patients, 69 (10.75%) died, 35 (50.73%) of them having VTE as a main cause of death. More patients died among secondary VTE (55 deaths of 371 secondary VTE, 14.8%) than among idiopathic VTE patients (14 deaths of 271 idiopathic VTE, 5.2%) (P < 0.001). Summary/Conclusion: Many cases of secondary VTE had more than one underlying non inherited condition for development of VTE. The most common risk factors for VTE were malignancy, trauma, surgery, and immobilization. Secondary VTE had higher mortality than idiopathic VTE. As non inherited risk factors for VTE, such as surgery and cancer, are applicable to more people, improved thromboprophylaxis in these settings might substantially lower the incidence of VTE.

Venous thromboembolism ; incidence ; Croatia

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