Estimating the Incidence of Symptomatic Postoperative Venous Thromboembolism: The Importance of Perspective

Venous thromboembolism (VTE) is a major health care problem, with an incidence of 1 per 1000 person-years.¹ Sudden death is the initial clinical presentation for nearly one-quarter of patients with pulmonary embolism. VTE frequently recurs and is associated with long-term complications, including postthrombotic syndrome and pulmonary hypertension. Despite extensive efforts to identify VTE risk factors and to develop and implement effective and safe VTE prophylaxis, the incidence of VTE has not changed significantly.¹ The large number of potentially preventable US deaths attributable to VTE prompted the 2008 Surgeon General's Call to Action to Prevent Deep Vein Thrombosis and Pulmonary Embolism.² Recent hospitalization for major surgery accounts for almost one-quarter of all incident VTE events, and total hip replacement (THR) and total knee replacement (TKR) surgery are 2 of the surgeries posing the highest risk for VTE.¹