Epidemiology of venous thromboembolism: implications for clinical practice

Venous thromboembolism (VTE), encompassing deep vein thrombosis (DVT) and pulmonary embolism (PE), is a common disorder with annual incidence rates of 150 (95% CI, 131–169), 90 (95% CI, 72–109) and 67 (95% CI, 54–80) per 100 000 population for VTE, DVT, and PE, respectively in Western countries. Of note, reported VTE incidences are considerably lower in East Asia. VTE incidence increases with age and is comparable between sexes, although men exhibit a higher risk of recurrence. Incidence rates of PE, but not of DVT, have been increasing in the last decades, reflecting changes in diagnostic workup and risk factors. VTE has a significant impact on mortality, and it is estimated that death from PE, which includes sudden death from undiagnosed, untreated PE, may be responsible for approximately 3% of all deaths. Nevertheless, diagnosed and treated VTE still carries a substantial risk with case fatality rates up to 10% in contemporary cohorts. Even when conservative calculations are applied, VTE death rate is approximately 26 (95% CI, 19–32) per 100 000, which makes it—at least in Europe and North America— the third most common reason of death from cardiovascular diseases and fifth from all causes. In this article, we summarize the current state of knowledge and recent data on the epidemiology of VTE with a particular focus on mortality from PE and its clinical implications.