PCV3 - a descriptive analysis of patient characteristics, bleeding and recurrence risk among u.s veteran patients diagnosed with venous thromboembolism

Abstract

Objectives: Patient characteristics and bleeding and recurrence risk of venousthromboembolism (VTE) were assessed among patients in the Veterans HealthAdministration (VHA) population. Methods: Adult patients (?18 years) with VTE(International Classification of Diseases, 9th Revision, Clinical Modification codes:451-453, 671.3, 671.4 and 671.9 deep vein thrombosis [DVT]; 415.1, 673.2, 673.8 pulmonary embolism [PE]) were identified from the VHA Medical SAS datasets. Theindex date was defined as the first VTE diagnosis date between 01APR2006 and30SEP2012. Patients were required to have ?2 outpatient VTE diagnosis claimswithin 3 weeks and one inpatient stay with a VTE diagnosis, continuous healthplan enrollment for 6 months pre-index date and no VTE diagnosis (V12.51, V12.52)in the baseline period. Patient data were assessed until the earlier of death or endof the study period. Outcomes of interest included VTE recurrence, major bleedingand clinically-relevant non-major bleeding (CRNM). The incidence rate (per 100person-year) was calculated for VTE recurrence and bleeding outcomes. Results:Total 88,280 VTE patients were identified, of which 67.6% had DVT and 24.9% had PE.VTE patients were mean age 66 years, 95.9% were male and more often resided inthe Southern U.S. region (37%). The baseline Charlson comorbidity index score was3.3 and common comorbid conditions included hypertension (56.00%), respiratorydisease (34.3%) and heart disease (34.3%). Non-steroidal anti-inflammatory drugs(60.10%), antidepressants (33.00%) and anticoagulants (36.8%) were also frequentlyprescribed in the baseline period. During the follow-up period, 37.5% of VTE casesoccurred in outpatient settings and 62.50% occurred in inpatient settings. The incidence rate for VTE recurrence (20.7%) was 10.5 per 100 person-years, major bleeding (21.9%) was 10.9 per 100 person-years and CRNM (23.00%) was 12.1 per 100person-years. Conclusions: U.S. veteran patients diagnosed with VTE had frequent comorbid conditions and were at high-risk for bleeding and VTE recurrence.