Document Detail

Venous thromboembolism in very elderly patients: findings from a prospective registry (RIETE).
MedLine Citation:
PMID:  16885044     Owner:  NLM     Status:  MEDLINE    
BACKGROUND AND OBJECTIVES: Elderly patients with venous thromboembolism (VTE) have an increased rate of bleeding complications on therapeutic doses of anticoagulant therapy. DESIGN AND METHODS: Using data in RIETE, an international registry of consecutive patients with objectively confirmed, symptomatic acute VTE, we analyzed the clinical characteristics and outcome within 90 days of therapy of all enrolled patients aged > or = 80 years old. RESULTS: Of the 13,011 patients with VTE enrolled in RIETE up tp September 2005, 2890 (22%) were aged > or = 80 years old. During the study period 99 patients (3.4%) aged > or = 80 years, and 212 aged < 80 years (2.1%) had major bleeding events (odds ratio: 1.7; 95% CI: 1.3-2.1). Fatal bleeding occurred in 0.8% and 0.4%, respectively (odds ratio: 2.0; 95% CI: 1.2-3.4). The incidence of recurrent VTE was 2.1% and 2.8%. However, 3.7% of patients > or = 80 years and 1.1% < 80 years died of pulmonary embolism (PE) (odds ratio: 3.6; 95% CI: 2.7-4.7). On multivariate analysis, patients > or = 80 years with symptomatic PE, heart failure, long-term therapy with low-molecular-weight heparin (LMWH) or a vena cava filter had an increased risk of recurrent VTE. Those with recent bleeding, abnormal renal function, use of corticosteroids or long-term therapy with LMWH had an increased risk of major bleeding. INTERPRETATION AND CONCLUSIONS: In patients aged > or = 80 years old the 3.4% incidence of major bleeding exceeded the 2.1% incidence of VTE recurrences. However, the 3.7% incidence of fatal PE outweighed the 0.8% of fatal bleeding. Thus, there seems to be more reason to be concerned about fatal PE than about bleeding in elderly patients with VTE.
Luciano López-Jiménez; Manuel Montero; José Antonio González-Fajardo; Juan Ignacio Arcelus; Carmen Suárez; José Luís Lobo; Manuel Monreal;
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Haematologica     Volume:  91     ISSN:  1592-8721     ISO Abbreviation:  Haematologica     Publication Date:  2006 Aug 
Date Detail:
Created Date:  2006-08-03     Completed Date:  2006-09-27     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0417435     Medline TA:  Haematologica     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  1046-51     Citation Subset:  IM    
Servicio de Medicina Interna, Hospital Universitario, Reina Sofía, Córdoba, Spain.
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MeSH Terms
Aged, 80 and over
Follow-Up Studies
Prospective Studies
Pulmonary Embolism / epidemiology
Survival Rate
Thromboembolism / mortality,  physiopathology*
Venous Thrombosis / mortality,  physiopathology*

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