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Incidence of venous thromboembolism in care homes : a prospective cohort study

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Apenteng, Patricia N., Hobbs, FD Richard, Roalfe, Andrea, Muhammad, Usman, Heneghan, Carl and Fitzmaurice, David (2017) Incidence of venous thromboembolism in care homes : a prospective cohort study. British Journal of General Practice, 67 (655). e130-e137. doi:10.3399/bjgp17X688873 ISSN 0960-1643.

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Official URL: http://dx.doi.org/10.3399/bjgp17X688873

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Abstract

Background: Care home residents have venous thromboembolism (VTE) risk profiles similar to medical inpatients; however, the epidemiology of VTE in care homes is unclear.

Aim: To determine the incidence of VTE in care homes.

Design and setting: Observational cohort study of 45 care homes in Birmingham and Oxford, UK.

Method: A consecutive sample of care home residents was enrolled and followed up for 12 months. Data were collected via case note reviews of care home and GP records; mortality information was supplemented with Health and Social Care Information Centre (now called NHS Digital) cause of death data. All potential VTE events were adjudicated by an independent committee according to three measures of diagnostic certainty: definite VTE (radiological evidence), probable VTE (high clinical indication but no radiological evidence), or possible VTE (VTE cannot be ruled out). (Study registration number: ISTCTN80889792.)

Results: There were 1011 participants enrolled, and the mean follow-up period was 312 days (standard deviation 98 days). The incidence rate was 0.71 per 100 person years of observation (95% confidence interval [CI] = 0.26 to 1.54) for definite VTE, 0.83 per 100 person years (95% CI = 0.33 to 1.70) for definite and probable VTE, and 2.48 per 100 person years (95% CI = 1.53 to 3.79) for definite, probable, and possible VTE.

Conclusion: The incidence of VTE in care homes in this study (0.71–2.48 per 100 person years) is substantial compared with that in the community (0.117 per 100 person years) and in people aged ≥70 years (0.44 per 100 person years). Further research regarding risk stratification and VTE prophylaxis in this population is needed.

Item Type: Journal Article
Divisions: Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Clinical Trials Unit
Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences
Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School
Journal or Publication Title: British Journal of General Practice
Publisher: Royal College of General Practitioners
ISSN: 0960-1643
Official Date: 26 January 2017
Dates:
DateEvent
26 January 2017Available
10 October 2016Accepted
Volume: 67
Number: 655
Page Range: e130-e137
DOI: 10.3399/bjgp17X688873
Status: Peer Reviewed
Publication Status: Published
Access rights to Published version: Restricted or Subscription Access

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