Thirty-Day Case-Fatality Rates for Pulmonary Embolism in the Elderly

Siddique, Reshmi; Siddique, Mahmood I.; Connors, Alfred F.; Rimm, Alfred A.

doi:10.1001/archinte.1996.00440190097010

Cited by 63 publications

(6 citation statements)

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“…Whilst the above studies found no difference in short term mortality between ethnic groups, evidence from other studies is conflicting, suggesting a higher short‐term mortality in African‐Americans following a PE (Siddique et al , 1996; Stein et al , 2003, 2004a) (Table III). These studies raise a number of confounding factors, such as access to treatment, time to presentation, mode of treatment and various co‐morbidities, which may all contribute to this observed discrepancy.…”

Section: Epidemiology Of Vtementioning

confidence: 89%

“…Whilst there is a body of evidence slowly emerging in the field of ethnicity and VTE, there remains a lack of high quality prospective research. Much of the epidemiological work investigating ethnicity and VTE has arisen from USA and, unfortunately, the vast majority of this involved analysis of retrospective data (Siddique et al , 1996; White et al , 1998, 2004, 2005; Stein et al , 2004a,b,c; Schneider et al , 2006), with a single ongoing prospective case–control study reported (Dowling et al , 2003). In the UK, only a single prospective case–control study has been published in this field (Patel et al , 2003).…”

Section: Discussionmentioning

confidence: 99%

“…Subsequent work in ethnically diverse populations has demonstrated that VTE is a significant problem in other ethnic groups including African Americans and the UK black population. Debate persists as to whether ethnicity influences the natural history of VTE with some evidence of higher rates of PE (Stein et al , 1999; White et al , 2005; Schneider et al , 2006) and also of increased early morbidity and mortality in African‐Americans (Siddique et al , 1996; Stein et al , 2003, 2004a). This does not appear to reflect differences in access or quality of healthcare (Stein et al , 2003; Aujesky et al , 2007).…”

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confidence: 99%

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Venous thromboembolism and ethnicity

2009

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SummaryVenous thromboembolism (VTE) has long been considered a disease that affects predominantly white populations, a misconception resulting from a paucity of epidemiological data from non-Western countries, and the low incidence of hereditary thrombophilia in those of non-Caucasian background. Over the last decade, interest has grown in this area with the emergence of evidence that VTE is as prevalent, if not more so, in the black population and is also common in Asian groups. Much is still to be learned, as our current knowledge of hereditary thrombophilia and acquired risk factors do not fully explain the risk of VTE in non-Caucasian groups. This review summarises the current understanding of ethnic variation in VTE and highlights the need for further research in this area.

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Section: Epidemiology Of Vtementioning

confidence: 89%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Venous thromboembolism and ethnicity

2009

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“…Rates were greatest among women with cancer-related VTE, with 28-day and 1-year case-fatalities of 16% and 54%, respectively. Other studies have identified cancer patients with VTE to be at an exceptionally elevated risk of mortality(9, 23–26). These individuals may be immobile as a consequence of the cancer, and/or may have a thrombotic diathesis due to the cancer and/or its treatment.…”

Section: Discussionmentioning

confidence: 99%

Correlates and Consequences of Venous Thromboembolism: The Iowa Women's Health Study

et al. 2010

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Objectives-To document the incidence, case-fatality, and recurrence of venous thromboembolism (VTE) in women, and to explore the relation of demographic, lifestyle, and anthropometric factors to VTE incidence. Methods-In 1986Iowa women aged 55-69 completed a mailed survey. These data were linked to Medicare data for 1986-2004 (n=40,377) to identify hospitalized VTE cases. Cox regression adjusted for age, education, smoking status, physical activity, and BMI.Results-2,137 women developed VTE, yielding an incidence rate of 4.04/1,000 person-years. The 28-day case-fatality was 7.7% and the 1-year recurrence, 3.4%. Educational attainment and age-at-menopause were inversely associated with VTE, as was physical activity, prior to BMI adjustment. The risk of secondary (particularly cancer-related) VTE was increased in smokers compared with never smokers. BMI, waist circumference, waist-hip-ratio height, and diabetes were positively associated with VTE risk. Hormone replacement therapy use was associated with increased risk of idiopathic VTE, while parity was unrelated. Human Subjects StatementThe University of Minnesota Institutional Review Board approved this study, and all participants gave informed consent.Author Contributions PL Lutsey, AR Folsom, and BA Virnig designed the study and led in writing the manuscript. PL Lutsey conducted the analysis, with assistance from SB Durham and DR Jacobs, Jr. All authors helped to conceptualize ideas, interpret findings, and review drafts of the manuscript. NIH Public Access Author ManuscriptAm J Public Health. Author manuscript; available in PMC 2011 August 1. NIH-PA Author ManuscriptConclusions-VTE is a significant source of morbidity and mortality in older women. Risk was elevated among women who were smokers, physically inactive, overweight, and diabetic, indicating that lifestyle contributes to VTE risk.

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“…3 PE is a major contributing factor or cause of death within the first 30 days after hospital admission in as many as 16% of patients, particularly in the elderly. 4 Most clinically significant PE originate in the proximal veins of the lower extremity. 5,6 PE is a major cause of death in hospitalized patients, occurring in 1% to 2%, 7 with the 3-month mortality ranging from 10% to 17.5%.…”

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confidence: 99%

Treatment of Symptomatic Venous Thromboembolism: Improving Outcomes

Büller¹

2002

Semin Thromb Hemost

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Antithrombotic therapy with unfractionated heparin (UFH) and warfarin for the treatment of deep venous thrombosis (DVT) and pulmonary embolism (PE) became widely accepted in the early 1960s. Subsequent clinical trials have focused on the importance of early intravenous UFH in the treatment of venous thromboembolic events, the method of heparin administration, the importance of rapid anticoagulation to prevent recurrent venous thromboembolism (VTE), and the optimal duration of UFH administration. Low-molecular-weight heparin (LMWH) represents a significant advance over UFH therapy for VTE. Developed in the late 1980s, LMWH has become an excellent alternative to UFH because it offers superior efficacy and safety, improved pharmacokinetics, longer half-life, and once- or twice-daily subcutaneous administration without the need for laboratory monitoring. Fondaparinux is the first of a new class of antithrombotic agents that targets factor Xa. Based on studies of the heparin binding site of antithrombin, this novel pentasaccharide has superior pharmacokinetics and bioavailability when compared with LMWH and can be administered once daily. Studies in patients undergoing major orthopedic surgery and in those with proximal DVT indicate that the efficacy and safety of fondaparinux may represent an improvement over those of LMWH.

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Thirty-Day Case-Fatality Rates for Pulmonary Embolism in the Elderly

Cited by 63 publications

References 19 publications

Venous thromboembolism and ethnicity

Venous thromboembolism and ethnicity

Correlates and Consequences of Venous Thromboembolism: The Iowa Women's Health Study

Treatment of Symptomatic Venous Thromboembolism: Improving Outcomes

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