Effects of age on the risk of dying from pulmonary embolism or bleeding during treatment of deep vein thrombosis

Muñoz-Torrero, Juan Francisco Sánchez; Bounameaux, Henri; Pedrajas, José María; Lorenzo, Alicia; Rubio, Silvino; Kearon, Clive; Hernández, Luís; Monreal, Manuel

doi:10.1016/j.jvs.2011.05.114

Cited by 55 publications

(29 citation statements)

References 19 publications

(13 reference statements)

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“…However, clinical care should be based on a broader set of medical outcomes than just mortality, and only half of PE patients dying within the first 30 days had a PE-related death. [10][11][12][13] In the current analysis, we tried to identify characteristics associated with the occurrence of the composite outcome of recurrent PE, major bleeding or death within the first 10 days of therapy. 9 Therefore, improvements in the risk stratification of patients with PE are still needed.…”

mentioning

confidence: 99%

Identification of Low-Risk Patients with Acute Symptomatic Pulmonary Embolism for Outpatient Therapy

Trujillo‐Santos¹,

Riera‐Mestre²,

Jiménez³

et al. 2015

Annals ATS

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confidence: 99%

Identification of Low-Risk Patients with Acute Symptomatic Pulmonary Embolism for Outpatient Therapy

Trujillo‐Santos¹,

Riera‐Mestre²,

Jiménez³

et al. 2015

Annals ATS

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“…On multivariate analysis, fatal PE was significantly more common in patients with recent immobility. Finally, we assessed the risk of fatal PE and fatal bleeding in 16,199 patients with lower limb DVT (without symptomatic PE at the time of inclusion), with patients categorized according to age 6. During the first 3 months of treatment, there were 31 fatal PE (0.19%) and 83 fatal bleeds (0.51%).…”

Section: Study Supportmentioning

confidence: 99%

VTE Registry: What Can Be Learned from RIETE?

Tzoran¹,

Brenner²,

Papadakis³

et al. 2014

Rambam Maimonides Med J

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The Registro Informatizado de Enfermedad TromboEmbólica (RIETE Registry) is an ongoing, international, prospective registry of consecutive patients with acute venous thromboembolism (VTE) designed to gather and analyze data on treatment patterns and outcomes in patients with acute VTE. It started in Spain in 2001, and 6 years later the database was translated into English with the aim to expand the Registry to other countries. In contrast to randomized controlled trials, there is no imposed experimental intervention: the management is determined solely by physicians. Thus, it provides data on patients with VTE in a real-world situation with an unselected patient population. Data from RIETE are hypothesis-generating and provide feedback from real-world clinical situations. So far, we learned about the natural history of VTE in patients with relative or absolute contraindications to anticoagulant therapy. We also learned interesting aspects on the natural history of VTE, and we built a number of prognostic scores to identify VTE patients at low, moderate, or high risk for adverse outcome.

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“…The RIETE (Registro Informatizado de Enfermedad TromboEmbólica) Registry is an ongoing, multicenter, international (Spain, Italy, France, Israel, Portugal, Germany, Switzerland, Czech Republic, Republic of Macedonia, Greece, Canada and Ecuador), observational registry of patients with symptomatic, objectively confirmed, acute VTE (ClinicalTrials.gov identifier: NCT02832245). Data from this registry have been used to evaluate outcomes after acute VTE, such as the frequency of recurrent VTE, bleeding and mortality, and risk factors for these outcomes . In the current analysis, we compared the effectiveness and safety of the two different dosing strategies of enoxaparin (once vs. twice daily) in the initial therapy of patients with acute VTE.…”

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confidence: 99%

Once versus twice daily enoxaparin for the initial treatment of acute venous thromboembolism

Trujillo‐Santos

Bergmann

Bortoluzzi

et al. 2017

Journal of Thrombosis and Haemostasis

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Background In patients with acute venous thromboembolism (VTE), it is uncertain whether enoxaparin should be administered twice or once daily. Methods We used the RIETE Registry data to compare the 15- and 30-day rates of VTE recurrence, major bleeding and death between patients receiving enoxaparin twice daily and those receiving it once daily. We used propensity score matching to adjust for confounding variables. Results The study included 4730 patients: 3786 (80%) received enoxaparin twice daily and 944 once daily. During the first 15 days, patients on enoxaparin once daily had a trend towards more VTE recurrences (odds ratio [OR], 1.79; 95% confidence interval [CI], 0.55-5.88), fewer major bleeds (OR, 0.42; 95% CI, 0.17-1.08) and fewer deaths (OR, 0.32; 95% CI, 0.13-0.78) than those on enoxaparin twice daily. At day 30, patients on enoxaparin once daily had more VTE recurrences (OR, 2.5; 95% CI, 1.03-5.88), fewer major bleeds (OR, 0.40; 95% CI, 0.17-0.94) and fewer deaths (OR, 0.58; 95% CI, 0.33-1.00). On propensity analysis, patients on enoxaparin once daily had fewer major bleeds at 15 (hazard ratio [HR], 0.30; 95% CI, 0.10-0.88) and at 30 days (HR, 0.16; 95% CI, 0.04-0.68) and also fewer deaths at 15 (HR, 0.37; 95% CI, 0.14-0.99) and at 30 days (HR, 0.19; 95% CI, 0.07-0.54) than those on enoxaparin twice daily. Conclusions Our findings confirm that enoxaparin prescribed once daily results in fewer major bleeds than enoxaparin twice daily, as suggested in a meta-analysis of controlled clinical trials.

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Effects of age on the risk of dying from pulmonary embolism or bleeding during treatment of deep vein thrombosis

Abstract: During the first week of treatment, the risk of fatal bleeding and fatal PE were similar. Then, particularly in patients who were aged ≥ 60 years, the risk of dying from bleeding exceeded the risk of dying from PE.

Cited by 55 publications

References 19 publications

Identification of Low-Risk Patients with Acute Symptomatic Pulmonary Embolism for Outpatient Therapy

Identification of Low-Risk Patients with Acute Symptomatic Pulmonary Embolism for Outpatient Therapy

VTE Registry: What Can Be Learned from RIETE?

Once versus twice daily enoxaparin for the initial treatment of acute venous thromboembolism

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