Document Detail


Venous thromboembolism in very elderly patients: findings from a prospective registry (RIETE).
MedLine Citation:
PMID:  16885044     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Luciano López-Jiménez; Manuel Montero; José Antonio González-Fajardo; Juan Ignacio Arcelus; Carmen Suárez; José Luís Lobo; Manuel Monreal;
Related Documents :
2733994 - Intraocular human thrombin infusion in diabetic vitrectomies.
8421474 - Recombinant factor viii for the treatment of previously untreated patients with hemophi...
2091364 - Onyalai at rundu, namibia 1981-1988: age, sex, morbidity, mortality and seasonal variat...
23265034 - Combined axillary block with "selective" injection of nerves and the axillary catheter:...
24074404 - Percutaneous pigtail catheter versus tube thoracostomy for pediatric empyema: a compari...
23525964 - Comparison of bulking agents in the treatment of fecal incontinence: a prospective rand...
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    
Affiliation:
Servicio de Medicina Interna, Hospital Universitario, Reina Sofía, Córdoba, Spain.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Aged, 80 and over
Follow-Up Studies
Humans
Prospective Studies
Pulmonary Embolism / epidemiology
Survival Rate
Thromboembolism / mortality,  physiopathology*
Venous Thrombosis / mortality,  physiopathology*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  The course of severe autoimmune thrombocytopenia in patients not undergoing splenectomy.
Next Document:  Out of hospital treatment with subcutaneous low molecular weight heparin in patients with acute deep...