Epidemiology of deep venous thrombosis in US emergency departments during an 8-year period

Eric Moyer; Kyle Bernard; Michael Gottlieb

doi:10.15441/ceem.24.299

Clin Exp Emerg Med > Accepted Articles

Original Article

doi: https://doi.org/10.15441/ceem.24.299 [Accepted]

Epidemiology of deep venous thrombosis in US emergency departments during an 8-year period

Eric Moyer¹

, Kyle Bernard²

, Michael Gottlieb¹

¹Department of Emergency Medicine, Rush University Medical Center, Chicago, IL, USA
²Department of Emergency Medicine, Medical College of Wisconsin, Milwaukee, WI, USA

Correspondence Michael Gottlieb Email: MichaelGottliebMD@gmail.com

Received: August 2, 2024. Revised: August 30, 2024. Accepted: September 2, 2024. Published online: October 16, 2024.

ABSTRACT

Objective
Deep vein thrombosis (DVT) is a significant cause of morbidity and mortality worldwide, accounting for substantial healthcare utilization. However, management strategies have evolved, and current data on the incidence, admission rates, and medical management of DVT in the emergency department (ED) setting are needed.
Methods
This cross-sectional study analyzed ED presentations for DVT from 2016 to 2023 using the Cosmos database. Inclusion criteria were patients aged ≥18 years with an ICD-10 code for acute extremity DVT. The outcomes were incidence rates, admission rates, and anticoagulant prescriptions. Data were analyzed using descriptive statistics, and subgroup analyses were performed for upper and lower extremity DVTs.
Result
s: Of 190,144,463 total ED encounters, 368,044 (0.2%) were due to DVT. Among the DVT cases, 119,986 patients (32.6%) were admitted, at a stable rate during the study period. Apixaban was the most prescribed anticoagulant (40.3%), followed by rivaroxaban (28.3%), enoxaparin (7.9%), warfarin (3.6%), and dabigatran (0.3%). Use of apixaban increased from 12.4% in 2016 to 56.2% in 2023. Lower extremity DVTs accounted for 88.5% of cases, with a 32.1% admission rate, whereas upper extremity DVTs accounted for 11.7% of cases, with a 37.0% admission rate.
Conclusion
This study provides a summary of DVT presentation and management in US EDs during an 8-year period. The findings highlight stable incidence rates, reduced admission rates compared with historical data, and a significant shift toward the use of direct oral anticoagulants, particularly apixaban, for outpatient management. These trends underscore the importance of evidence-based practices and ongoing research to optimize DVT management and improve patient outcomes.

Keywords: Epidemiology; Deep venous thrombosis; Venous thromboembolism