The influence of extreme body weight on clinical outcome of patients with venous thromboembolism: findings from a prospective registry (RIETE)

Abstract

The influence of extreme body weight on clinical outcome of patients with venous thromboembolism: findings from a prospective registry (RIETE). Summary. Background: Data evaluating the safety of using weight-based dosing of low-molecular-weight heparin (LMWH) in either underweight or obese patients with venous thromboembolism (VTE) are limited. Thus, recommendations based on evidence from clinical trials might not be suitable for patients with extreme body weight. Patients and Methods: Patients with objectively confirmed, symptomatic acute VTE are consecutively enrolled into the Registro Informatizado de la Enfermedad TromboEmbo´lica (RIETE) registry. For this analysis, data from patients in the following ranges of body weight were examined: <50, 50-100, and >100 kg. Patient characteristics, underlying conditions, treatment schedules and clinical outcomes during the first 15 days of treatment were compared. Results: As of August 2004, 8845 patients with acute VTE were enrolled from 94 participating centers. Of these, 169 (1.9%) weighed <50 kg, 8382 (95%) weighed 50-100 kg and 294 (3.3%) weighed >100 kg. Patients weighing <50 kg were more commonly females, were taking non-steriodal antiinflammatory drugs (NSAIDs), and had severe underlying diseases more often than patients weighing 50-100 kg. Their incidence of overall bleeding complications was significantly higher than in patients weighing 50-100 kg (odds ratio 2.2; 95% CI: 1.2-4.0). Patients weighing >100 kg were younger, most commonly males, and had cancer less often than those weighing 50-100 kg. Incidences of recurrent VTE, fatal pulmonary embolism or major bleeding complications were similar in both groups. Conclusions: Patients with VTE weighing <50 kg have a significantly higher rate of bleeding complications. The clinical outcome of patients weighing over 100 kg was not significantly different from that in patients weighing 50-100 kg.

Haemodynamically unstable pulmonary embolism in the RIETE Registry: systolic blood pressure or shock index?

“…The Registro Informatizado de la Enfermedad Tromboembó lica (RIETE) initiative is an ongoing, international (Spain, France, Italy, Israel and Argentina), multicentre, prospective registry of consecutive patients presenting with symptomatic acute venous thromboembolism (VTE) confirmed by objective tests [12][13][14][15][16]. The aim of the present study was to compare the predictive value of the three clinical parameters (shock index, SBP ,100 mmHg and SBP ,90 mmHg) on 30-day mortality in all patients with acute PE.…”

Deep Vein Thrombosis and Pulmonary Embolism: The Same Disease?

“…RIETE is an ongoing registry of consecutive patients with acute VTE (3)(4)(5)(6)(7). In this study, all enrolled patients were classified into three groups: patients with symptomatic PE alone, those with symptomatic DVT, or those with symptoms of both DVT and PE.…”

Using low molecular weight heparin in special patient populations

“…Compared to patients weighing 50-100 kg, bleeding and thrombotic outcomes did not differ significantly among 294 patients weighing over 100 kg in the prospective RI-ETE registry [33]. In the retrospective analysis of the TIMI IIb and ESSENCE studies, the rate of major hemorrhage did not differ between obese patients compared to nonobese patients (0.8 vs. 1.3%), and there was no difference between UFH and enoxaparin (1.2 vs. 0.4%) [21].…”