Venous thromboembolism incidence, recurrence, and mortality based on Women's Health Initiative data and Medicare claims

Our objective was to compare Medicare claims to physician review and adjudication of medical records for identifying venous thromboembolism (VTE), and to assess VTE incidence, recurrence, and mortality in a large national cohort of post-menopausal women followed up to 19years. We used detailed clini...

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Bibliographic Details
Published in:Thrombosis research 2017-02, Vol.150, p.78-85
Main Authors: Burwen, Dale R., Wu, Chunyuan, Cirillo, Dominic, Rossouw, Jacques E., Margolis, Karen L., Limacher, Marian, Wallace, Robert, Allison, Matthew, Eaton, Charles B., Safford, Monika, Freiberg, Matthew
Format: Article
Language:English
Subjects:
Administrative Claims, Healthcare
Age Factors
Aged
Cohort Studies
Deep venous thrombosis
Female
Humans
Incidence
Medical Records
Medicare
Medicare claims
Middle Aged
Neoplasms - complications
Pulmonary embolism
Recurrence
United States - epidemiology
Venous thromboembolism
Venous Thromboembolism - complications
Venous Thromboembolism - epidemiology
Venous Thromboembolism - mortality
Women's Health
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Summary:Our objective was to compare Medicare claims to physician review and adjudication of medical records for identifying venous thromboembolism (VTE), and to assess VTE incidence, recurrence, and mortality in a large national cohort of post-menopausal women followed up to 19years. We used detailed clinical data from the Women's Health Initiative (WHI) linked to Medicare claims. Agreement between data sources was evaluated among 16,003 women during 1993–2010. A claims-based definition was selected to analyze VTE occurrence and impact among 71,267 women during 1993–2012. Our VTE definition had 83% sensitivity. Positive predictive value was 69% when all records were included, and 94% after limiting Medicare records to those with a WHI hospitalization adjudicated. Annualized VTE incidence was 4.06/1000person-years (PY), recurrence was 5.30/100PY, and both rates varied by race/ethnicity. Post-VTE mortality within 1year was 22.49% from all causes, including 1.01% from pulmonary embolism, 10.40% from cancer, and 11.08% from other causes. Cancer-related VTE compared to non-cancer VTE had significantly (p
ISSN:0049-3848
1879-2472
DOI:10.1016/j.thromres.2016.11.015