Download the full-sized PDF of The Epidemiology of Venous Thromboembolism in Alberta, Canada: A Population Based Cohort Study.Download the full-sized PDF



Permanent link (DOI):


Export to: EndNote  |  Zotero  |  Mendeley


This file is in the following communities:

Graduate Studies and Research, Faculty of


This file is in the following collections:

Theses and Dissertations

The Epidemiology of Venous Thromboembolism in Alberta, Canada: A Population Based Cohort Study. Open Access


Other title
The Epidemiology of Venous Thromboembolism
Venous Thromboembolism
Health Outcome
Type of item
Degree grantor
University of Alberta
Author or creator
Alotaibi, Ghazi S
Supervisor and department
McMurtry, Michael Sean (Medicine)
Examining committee member and department
Carrier, Marc (University of Ottawa)
Kaul, Padma (School of Public Health)
Voaklander, Donald (School of Public Health)
Wu, Cynthia (Medicine)
Senthilselvan, Ambikaipakan (Sentil) (School of Public Health)
Department of Medicine

Date accepted
Graduation date
Doctor of Philosophy
Degree level
Background: Venous thromboembolism (VTE), comprises both deep vein thrombosis (DVT) and pulmonary embolism (PE). It is a common acute cardiovascular event associated with increased long-term morbidity, disability, all-cause mortality, and high rates of recurrence. Major advances in diagnosis, prophylaxis, and treatment over the past 3-decades have likely changed its clinical epidemiology. However, there are little published data describing contemporary, population-based, trends in VTE epidemiology. Objectives: To examine recent trends in the epidemiology of clinically recognized VTE and assess the disease burden in the Canadian province of Alberta. Methods: Initially, we developed and validated a VTE case identifying algorithm using a combination of International Classification of Diseases (ICD) diagnostic codes and a VTE related imaging procedure codes against patient charts. Then, two retrospective cohort studies based on linkage of administrative health databases in Alberta, Canada, provided estimates of VTE incidence and case fatality over the past decade. Also, we investigated the effect of cancer on overall, short- and long-term mortality in a cohort of consecutive incident PE patients. Poisson regression and Cox’s proportional hazard models were used in the multivariate analysis. Results: 1361 patients were used for the validation of the case-definition. The sensitivity and specificity of our algorithm for identifying patients with VTE using administrative data is 75% (95% CI: 69.18-80.22) and 93.78% (92.19-95.13), respectively. Subsequently, we identified 31,656 cases of acute symptomatic VTE between April 1, 2002, and March 31, 2012. The age and sex adjusted incidence rate of VTE was 1.38 (95% CI: 1.37, 1.40) per 1000 person-years. For pulmonary embolism it was 0.38 (95% CI: 0.36, 0.40) per 1000 person-years and for deep vein thrombosis it was 1.0 (95% CI: 0.99, 1.1) per 1000 person-years. The adjusted model showed no significant change in the incidence of VTE during the study period. The 30-day case fatality rate of VTE was 2.0% (95% CI: 1.89, 2.21) and was almost doubled in patients with PE 3.9% (95% CI: 3.50-4.33). The 1-year case fatality was 9.2% (95% CI: 8.88-9.52) for VTE and 12.9% (95% CI: 12.2-13.6) for patients with PE. In patients with PE, The 1-year and 5-year survival probabilities were 61% (95% CI: 57-64) and 39% (95% CI: 36-43) in cancer-associated PE patients, 93% (95% CI: 92-94) and 80% (95% CI: 78-81) in provoked PE patients, and 94% (95% CI: 93-95) and 85% (95% CI: 83-87) in unprovoked PE patients, respectively. Compared to patients with unprovoked PE events both short-term and long-term survival in patients with cancer-associated PE have significantly higher observed risk of all-cause mortality in all age groups, P-value <0.001. In contrast, patients with provoked events had similar short- and long-term hazard of death. Conclusion: Venous thromboembolism is a disease with significant morbidity and mortality. Despite advances in identification, prophylaxis, and treatment in the last decade, the disease burden remains high. While this may be partially due to increased sensitivity of diagnostic methods, especially for PE, it may also imply that current prevention and treatment strategies are less than optimal.
This thesis is made available by the University of Alberta Libraries with permission of the copyright owner solely for the purpose of private, scholarly or scientific research. This thesis, or any portion thereof, may not otherwise be copied or reproduced without the written consent of the copyright owner, except to the extent permitted by Canadian copyright law.
Citation for previous publication
Alotaibi GS, Wu C, Senthilselvan A, McMurtry MS. The validity of ICD codes coupled with imaging procedure codes for identifying acute venous thromboembolism using administrative data. Vascular medicine. 2015; 20: 364-8. 10.1177/1358863X15573839.Alotaibi GS, Wu C, Senthilselvan A, McMurtry MS. Secular trends in incidence and mortality of acute venous thromboembolism: The AB-VTE population based study. The American journal of medicine. 2016. 10.1016/j.amjmed.2016.01.041.

File Details

Date Uploaded
Date Modified
Audit Status
Audits have not yet been run on this file.
File format: pdf (Portable Document Format)
Mime type: application/pdf
File size: 673838
Last modified: 2016:08:11 16:48:22-06:00
Filename: Alotaibi_Ghazi_S_201603_PhD.pdf
Original checksum: dcad79838c821fd7ea4d9d85068f9e28
Well formed: true
Valid: true
File title: Microsoft Word - The Epidemiology of Venous Thromboembolism in Alberta (TC OFF) GSA March 9-2016.docx
File author: Ghazi
Page count: 119
Activity of users you follow
User Activity Date