Trends in Hospitalization and In-Hospital Mortality From VTE, 2007 to 2016, in China

Zhu Zhang; Jieping Lei; Xiang Shao; Fen Dong; Jing Wang; Dingyi Wang; Sinan Wu; Wanmu Xie; Jun Wan; Hong Chen; Yingqun Ji; Qun Yi; Xiaomao Xu; Yuanhua Yang; Zhenguo Zhai; Chen Wang; China Venous Thromboembolism Study Group

doi:10.1016/j.chest.2018.10.040

Trends in Hospitalization and In-Hospital Mortality From VTE, 2007 to 2016, in China

Chest. 2019 Feb;155(2):342-353. doi: 10.1016/j.chest.2018.10.040. Epub 2018 Nov 9.

Authors

Zhu Zhang¹, Jieping Lei², Xiang Shao³, Fen Dong², Jing Wang⁴, Dingyi Wang², Sinan Wu², Wanmu Xie⁵, Jun Wan⁵, Hong Chen⁶, Yingqun Ji⁷, Qun Yi⁸, Xiaomao Xu⁹, Yuanhua Yang¹⁰, Zhenguo Zhai⁵, Chen Wang¹¹; China Venous Thromboembolism Study Group

Collaborators

China Venous Thromboembolism Study Group:
Jin Zhang, Peng Zhang, Yimin Mao, Xiaohong Yang, Xiaomao Xu, Guoguang Xia, Rui Zheng, Yuan Gao, Guangfa Zhu, Chenxi Zhu, Yingyun Fu, Hong Chen, Fangfei Yu, Jiulong Kuang, Ziqiang Li, Zhe Cheng, Rui Wu, Zhaozhong Cheng, Li Tong, Yanwen Jiang, Jie Sun, Qixia Xu, Huiyun Pan, Lihong Wang, Mian Zeng, Yanzhu Chen, Chunxiao Yu, Jing Hua, Yongjun Tang, Yingqun Ji, Jun An, Yongxiang Zhang, Yanyan Ding, Wei Zhang, Xiaomai Wu, Wenshu Chai, Jing Li, Qun Yi, Haixia Wang, Xiaoju Chen, Aizhen Zhang, Jun Han, Kejing Ying, Xiaoling Xu, Zhihong Shi, Jiaolin Sun, Qiuliang Zhao, Guangjie Liu, Jie Zhuo, Guochao Shi, Yongjie Ding, Zhihong He, Zhe Lang, Xiaoyun Hu, Fangfang Fan, Hong Liu, Guohua Sun, Guoqiang Xing, Yingqi Zhang, Guanli Su, Jixiang Ni, Tianming Zhao, Jun Wang, Nuofu Zhang, Simin Qin, Songping Huang, Qinghua Xu, Yunqiu Li, Qian Liu, Qi Wu, Li Li, Xisheng Chen, Zhiwei Niu, Jianan Huang, Daxiong Zeng, Yadong Yuan, Qian Tian, Jian Zhang, Xinpeng Han, Jingping Yang, Baoying Bo, Yurong Huang, Qian Luo, Guifen Pang, Hongfei Zheng, Ping Zhang, Ruhong Xu, Yunfeng Zhang, Songshi Ni, Shengqing Li, Yi Gong, Jie Zhang, Ling Zhu, Shuyue Xia, Yule Chang, Jian Zhang, Xinpeng Han, Yadong Yuan, Qian Tian, Hongyu Zhang, Xia Xu, Yiwen Zhang, Jingjing Pan, Zhiqiang Qin, Miaochan Lao, Jing Li, Zhihong Liu, Qin Luo, Jun Wang, Ning Wang, Huiqin Yang, Xiaoli Tang, Xiaomin Bai, Yanwei Chen, Dan Han, Shasha Shen, Chen Jin, Yanping Ye, Lijun Suo, Xiaoying Huang, Jialie Wang, Xiangyan Zhang, Guoru Yang, Guohua Yu, Shudong Zhang, Yinlou Yang, Jiangtao Cheng, Jie Duo, Hong Zhang, Ping Wang, Yueyue Li, Ping Wang, Changcheng Guo, Tao Bian, Shaoxi Cai, Zhenshun Cheng, Ting Wang, Yong He, Wentong Huang, Chengying Liu, Hongda Zhao, Fenglin Tu, Youming Zhu, Guizhen Tian

Affiliations

¹ Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China; National Clinical Research Center for Respiratory Diseases, Beijing, China; Graduate School of Peking Union Medical College, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China.
² Institute of Clinical Medical Sciences, China-Japan Friendship Hospital, Beijing, China; National Clinical Research Center for Respiratory Diseases, Beijing, China.
³ Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China; National Clinical Research Center for Respiratory Diseases, Beijing, China; Beijing University of Chinese Medicine, Beijing, China.
⁴ Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China; National Clinical Research Center for Respiratory Diseases, Beijing, China; Peking University Health Science Center, Beijing, China.
⁵ Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China; National Clinical Research Center for Respiratory Diseases, Beijing, China.
⁶ Department of Pulmonary and Critical Care Medicine, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
⁷ Department of Respiratory Medicine, First Affiliated Hospital of Dalian Medical University, Liaoning Province, China.
⁸ Department of Pulmonary and Critical Medicine, West China Hospital, Sichuan University, Sichuan Province, China.
⁹ Department of Pulmonary and Critical Care Medicine, Beijing Hospital, Beijing, China.
¹⁰ Department of Pulmonary and Critical Care Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing Institute of Respiratory Medicine, and the Department of Respiratory Medicine, Capital Medical University, Beijing, China.
¹¹ Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China; National Clinical Research Center for Respiratory Diseases, Beijing, China; Graduate School of Peking Union Medical College, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China. Electronic address: cyh-birm@263.net.

PMID: 30419233
DOI: 10.1016/j.chest.2018.10.040

Abstract

Background: VTE has emerged as a major public health problem. However, data on VTE burden in China are seldom reported.

Methods: This study collected data on patients with a principal diagnosis of VTE, pulmonary embolism (PE), or DVT by using the International Classification of Diseases, 10th Revision, from 90 hospitals across China. The trends in hospitalization rates, mortality, length of stay (LOS), and comorbidities from 2007 to 2016 were analyzed.

Results: In total, 105,723 patients with VTE were identified. For patients with VTE, the age- and sex-adjusted hospitalization rate increased from 3.2 to 17.5 per 100,000 population, and in-hospital mortality decreased from 4.7% to 2.1% (P < .001). The mean LOS declined from 14 to 11 days (P < .001). In addition, the data in 2016 showed that the hospitalization rate of VTE was higher in elderly male patients (male patients vs female patients, 155.3 vs 125.4 per 100,000 population in patients aged ≥ 85 years; P < .001) and in northern China (north vs south, 18.4 vs 13.4 per 100,000 population; P < .001). Higher mortality rates were found in patients with cancer and Charlson Comorbidity Index scores > 2. Similar trends were also observed in patients with PE and those with DVT. The hospitalization rate in China was much lower than that of the United States or selected sites in Canada and Europe, the LOS was much longer, and the in-hospital mortality rates were similar.

Conclusions: The hospitalization rates of VTE increased steadily, and the mortality declined. This study provides important information on the disease burden of VTE in China.

Keywords: DVT; VTE; hospitalization rate; mortality; pulmonary embolism.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Age Distribution
Aged
Aged, 80 and over
China / epidemiology
Female
Hospital Mortality
Hospitalization / statistics & numerical data*
Humans
Male
Middle Aged
Pulmonary Embolism / diagnosis
Pulmonary Embolism / mortality*
Pulmonary Embolism / therapy
Retrospective Studies
Sex Distribution
Venous Thromboembolism / diagnosis
Venous Thromboembolism / mortality*
Venous Thromboembolism / therapy
Young Adult