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Faculty of Medical Sciences

The incidence of venous thromboembolism reported in hospitals in New Zealand and the contribution of lower limb immobilisation to the rate of VTE : An observational cohort study using retrospectively collected data from the Ministry of Health of New Zeal

Berg, M. van den (Marthe) (2019) The incidence of venous thromboembolism reported in hospitals in New Zealand and the contribution of lower limb immobilisation to the rate of VTE : An observational cohort study using retrospectively collected data from the Ministry of Health of New Zeal. thesis, Medicine.

Full text available on request.

Abstract

Introduction: Venous thromboembolism (VTE) is a disease with significant consequences regarding morbidity and mortality. Lower limb immobilisation is an established risk factor for VTE, however, clear guidelines for the prevention of VTE in temporary lower limb immobilisation are lacking. The aim of this study is to evaluate the feasibility of a randomised controlled trial (RCT) with Rivaroxaban 10 mg once daily for the prevention of VTE in temporary lower limb immobilisation by assessing the annual incidence of VTE in the general population of New Zealand in 2017 and the contribution of temporary lower limb immobilisation to this incidence. Methods: An observational cohort study with retrospectively collected data from the Ministry of Health of New Zealand. All residents (1875 years of age) of New Zealand who have experienced VTE in 2017, according to the ICD10-AM-v8 codes reported in hospitals, were included. The rate of VTE preceded by lower limb immobilisation in the preceding 90 days was reported using the matching ICD-codes. Descriptive statistics were used and sample size calculations for the potential RCT were performed. Results: The incidence of VTE reported in hospitals in New Zealand in 2017 was 0.059%. Of the 2,015 VTE events reported the proportion of pulmonary embolism was higher than the proportion of deep venous thrombosis (64.3% versus 35.7%). Of 2,015 VTE events 740 (36.7%) were preceded by an event in the preceding 90 days. Of 2,015 VTE events 37 (1.8%) were preceded by temporary lower limb immobilisation. Conclusion: The reported incidence is likely to be an underestimation of the true VTE incidence due to missing data of deep venous thrombosis treated in the community. With the current reported incidence a RCT with Rivaroxaban is not feasible.

Item Type: Thesis (Thesis)
Supervisor name: Faculty supervisor: and Diercks, Prof. Dr. R.
Supervisor name: Local supervisor: and Braithwaite, Dr. Irene and Location: Medical Research Institute of New Zealand, Welling
Faculty: Medical Sciences
Date Deposited: 25 Jun 2020 10:46
Last Modified: 25 Jun 2020 10:46
URI: https://umcg.studenttheses.ub.rug.nl/id/eprint/763

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