| Clinical outcome of patients with major bleeding after venous thromboembolism. Findings from the RIETE Registry. | |
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MedLine Citation:
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PMID: 18989522 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The natural history of patients with venous thromboembolism (VTE) who develop a major bleeding complication while on anticoagulant therapy is not well known. RIETE is a prospective registry of consecutive patients with symptomatic, objectively confirmed, acute VTE. The clinical characteristics, treatment decisions and outcome of all VTE patients who had major bleeding during the first three months of anticoagulant therapy were retrospectively studied. As of January 2007, 17, 368 patients were included in RIETE. Of these, 407 (2.3%) had major bleeding during the study period: 144 gastrointestinal, 119 haematoma, 51 intracranial, 43 genitourinary, 50 other. In 286 (69%) patients anticoagulant therapy was discontinued, in 74 (18%) not modified, in 38 (9.1%) a vena cava filter was inserted. During the first 30 days after bleeding, 24 (5.9%) patients re-bled, 20 (4.9%) had recurrent VTE, 133 (33%) died. Of these, 75 died of bleeding, 12 of recurrent pulmonary embolism. Most deaths occurred shortly after the bleeding episode (median: 1 day). On multivariate analysis, insertion of a vena cava filter was the only variable independently associated with a lower incidence of fatal bleeding (odds ratio [OR]: 0.10; 95% confidence interval [CI]: 0.01-0.79) and all-cause mortality (OR: 0.21; 95% CI: 0.07-0.63). In conclusion, the occurrence of major bleeding in patients with VTE is outstanding in terms of overall mortality (33% within 30 days), fatal bleeding (18%) or re-bleeding (5.9%). However, these patients also have an increased incidence of recurrent VTE (4.9%) and fatal pulmonary embolism (1.2%). |
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Authors:
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José Antonio Nieto; Timoteo Camara; Elena Gonzalez-Higueras; Nuria Ruiz-Gimenez; Ricardo Guijarro; Pablo Javier Marchena; Manuel Monreal; |
Publication Detail:
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Type: Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Thrombosis and haemostasis Volume: 100 ISSN: 0340-6245 ISO Abbreviation: Thromb. Haemost. Publication Date: 2008 Nov |
Date Detail:
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Created Date: 2008-11-07 Completed Date: 2008-12-22 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7608063 Medline TA: Thromb Haemost Country: Germany |
Other Details:
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Languages: eng Pagination: 789-96 Citation Subset: IM |
Affiliation:
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Servicio de Medicina Interna, Hospital Virgen de la Luz, Cuenca, Spain. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Acute Disease Aged Aged, 80 and over Anticoagulants / adverse effects* Argentina / epidemiology Europe / epidemiology Female Hemorrhage / chemically induced*, mortality Humans Israel / epidemiology Male Middle Aged Odds Ratio Pulmonary Embolism / etiology, mortality, prevention & control* Recurrence Registries Retrospective Studies Risk Assessment Time Factors Treatment Outcome Vena Cava Filters Venous Thromboembolism / complications, drug therapy*, mortality |
| Chemical | |
Reg. No./Substance:
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0/Anticoagulants |
| Investigator | |
Investigator/Affiliation:
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J I Arcelus / ; R Barba / ; A Blanco / ; M Barron / ; I Casado / ; I Canas / ; F Conget / ; M De Zarraga / ; C Falga / ; C Fernandez-Capitan / ; L L Font / ; P Gallego / ; F Garcia-Bragado / ; R Guijarro / ; J Gutierrez / ; M R Gutierrez / ; L Hernandez / ; S Herrera / ; D Jimenez / ; P Jimenez / ; R Lecumberri / ; L Lopez / ; I Lopez / ; A Maestre / ; P J Marchena / ; J J Martin-Villasclaras / ; M Monreal / ; J Montes / ; M D Naufall / ; J A Nieto / ; M T Orue / ; R Otero / ; M Provenza / ; R Rabunal / ; A Riera / ; C Rodriguez / ; V Rosa / ; N Ruiz-Gimenez / ; M D Ruiz-Ribo / ; R Sandoval / ; J C Sahuquillo / ; A L Samperiz / ; J F Sanchez / ; R Sanchez / ; M Santa-Olalla / ; S Soler / ; M J Soto / ; R Tirado / ; J A Todoli / ; C Tolosa / ; F Uresandi / ; B Vasco / ; M Valdes / ; V Valdes / ; R Valle / ; J Vela / ; P Mismetti / ; K Rivron-Guillot / ; H Boccalon / ; D El Kouri / ; P Le Corvoisier / ; I Quere / ; F Dalla / ; R Duce / ; I Enea / ; R Poggio / ; P Prandoni / ; A Schenone / ; T Surico / ; E Tiraferri / ; A Visona / |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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