Incidence of venous thromboembolism in a homebound population

J Community Health. 2013 Jun;38(3):480-5. doi: 10.1007/s10900-012-9632-2.

Abstract

Venous thromboembolism (VTE) is a source of morbidity and mortality for high risk populations. The incidence of VTE has been characterized in many populations, but the incidence in homebound patients, a growing demographic, is unknown. The objective of this study was to estimate the incidence of VTE occurring at home in a cohort of patients enrolled in the Mount Sinai Visiting Doctor's Program (VDP), a home-based primary care program. The medical records of patients enrolled in the VDP over a 4 year period were examined. Incident VTE in a home setting was defined as the diagnosis of any symptomatic deep vein thrombosis or pulmonary embolism that did not occur during a hospitalization, within 4 weeks of a medical hospitalization, or within 12 weeks of a hospitalization for surgery. Functional status was abstracted for all patients, when available. Of 1,910 patients active during the study period, 39 cases of at-home VTE were identified (8.0 per 1,000 person years [95 % CI = 7.6-8.3]). Of these events, 30 of 39 were confirmed by radiological testing and considered definite, and 9 were considered probable. There was no statistically significant difference in age, race, or sex between the patients with and without VTE. In conclusion the estimated incidence of symptomatic VTE in a homebound population is low. There is insufficient evidence to support routine surveillance or prophylaxis strategies for VTE in homebound patients.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Female
  • Homebound Persons / statistics & numerical data*
  • Humans
  • Incidence
  • Male
  • New York City / epidemiology
  • Venous Thromboembolism / epidemiology*