Comparison of Presentation, Treatment, and Outcomes of Venous Thromboembolism in Long-Term Immobile Patients Based on Age

Kód výsledku v IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00179906%3A_____%2F23%3A10466368" target="_blank" >RIV/00179906:_____/23:10466368 - isvavai.cz</a>

Nalezeny alternativní kódy

RIV/00216208:11150/23:10466368

Výsledek na webu

<a href="https://verso.is.cuni.cz/pub/verso.fpl?fname=obd_publikace_handle&handle=D4Kcg34XsT" target="_blank" >https://verso.is.cuni.cz/pub/verso.fpl?fname=obd_publikace_handle&handle=D4Kcg34XsT</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1007/s11606-023-08058-x" target="_blank" >10.1007/s11606-023-08058-x</a>

Jazyk výsledku

angličtina

Název v původním jazyce

Comparison of Presentation, Treatment, and Outcomes of Venous Thromboembolism in Long-Term Immobile Patients Based on Age

Popis výsledku v původním jazyce

BackgroundChronic immobility is prevalent, especially as people age. However, little is known about venous thromboembolism (VTE) outcomes in this population.ObjectiveTo compare the presentation, treatment, and outcomes in chronically immobile (&gt;8 weeks) patients older vs. younger than 75 who presented with VTE.DesignAn observational international registry of patients with VTE.ParticipantsPatients with acute VTE from the &quot;Registro Informatizado Enfermedad TromboEmbolica&quot; (RIETE) registry who were chronically immobile.Main MeasuresBaseline characteristics, presenting signs and symptoms, treatment and outcomes including major bleeding, recurrent VTE, and mortality.Key ResultsAmong 4612 immobile patients (mean age 75.7 years, 34% male), 2127 (46%) presented with pulmonary embolism (PE). Patients &gt;75 years presented more often with dyspnea (44% vs. 38%) or altered mental status (23% vs. 8.1%) and less often with chest pain (13% vs. 18%). The median duration of anticoagulation was shorter in older compared with younger patients [126 vs. 169 days]. During the first 90 days of anticoagulation, major bleeding (4.0% vs. 2.2%), PE-related death (2.5% vs. 1.1%), and bleeding-related death (0.78% vs. 0.26%) occurred more frequently among older patients. In 3550 patients who received anticoagulation beyond 90 days, older patients had more major bleeding [4.23 vs. 2.21 events per 100 patient years]. After anticoagulation discontinuation, recurrent VTE and major bleeding occurred in 11.8 and 9.25 and 1.49 and 0.69 events per 100 patient years, respectively, both in similar rates in both groups. In multivariable analysis, after stopping anticoagulation, VTE recurrence was inversely associated with long-term facility residence [OR 0.51 (0.28-0.92)], anemia [OR 0.63 (0.42-0.95)], and anticoagulation duration &lt; 90 days [OR 0.38 (0.27-0.54)].ConclusionsChronically immobilized patients older than 75 years presenting with VTE experience a high rate of adverse events including major bleeding and recurrent VTE. When considering treatment beyond 90 days, we should account for bleeding, recurrence risk, and associated mortality.

Název v anglickém jazyce

Comparison of Presentation, Treatment, and Outcomes of Venous Thromboembolism in Long-Term Immobile Patients Based on Age

Popis výsledku anglicky

BackgroundChronic immobility is prevalent, especially as people age. However, little is known about venous thromboembolism (VTE) outcomes in this population.ObjectiveTo compare the presentation, treatment, and outcomes in chronically immobile (&gt;8 weeks) patients older vs. younger than 75 who presented with VTE.DesignAn observational international registry of patients with VTE.ParticipantsPatients with acute VTE from the &quot;Registro Informatizado Enfermedad TromboEmbolica&quot; (RIETE) registry who were chronically immobile.Main MeasuresBaseline characteristics, presenting signs and symptoms, treatment and outcomes including major bleeding, recurrent VTE, and mortality.Key ResultsAmong 4612 immobile patients (mean age 75.7 years, 34% male), 2127 (46%) presented with pulmonary embolism (PE). Patients &gt;75 years presented more often with dyspnea (44% vs. 38%) or altered mental status (23% vs. 8.1%) and less often with chest pain (13% vs. 18%). The median duration of anticoagulation was shorter in older compared with younger patients [126 vs. 169 days]. During the first 90 days of anticoagulation, major bleeding (4.0% vs. 2.2%), PE-related death (2.5% vs. 1.1%), and bleeding-related death (0.78% vs. 0.26%) occurred more frequently among older patients. In 3550 patients who received anticoagulation beyond 90 days, older patients had more major bleeding [4.23 vs. 2.21 events per 100 patient years]. After anticoagulation discontinuation, recurrent VTE and major bleeding occurred in 11.8 and 9.25 and 1.49 and 0.69 events per 100 patient years, respectively, both in similar rates in both groups. In multivariable analysis, after stopping anticoagulation, VTE recurrence was inversely associated with long-term facility residence [OR 0.51 (0.28-0.92)], anemia [OR 0.63 (0.42-0.95)], and anticoagulation duration &lt; 90 days [OR 0.38 (0.27-0.54)].ConclusionsChronically immobilized patients older than 75 years presenting with VTE experience a high rate of adverse events including major bleeding and recurrent VTE. When considering treatment beyond 90 days, we should account for bleeding, recurrence risk, and associated mortality.

Druh

J_imp - Článek v periodiku v databázi Web of Science

CEP obor

—

OECD FORD obor

30201 - Cardiac and Cardiovascular systems

Projekt

—

Návaznosti

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Rok uplatnění

2023

Kód důvěrnosti údajů

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Název periodika

Journal of General Internal Medicine

ISSN

0884-8734

e-ISSN

1525-1497

Svazek periodika

38

Číslo periodika v rámci svazku

8

Stát vydavatele periodika

US - Spojené státy americké

Počet stran výsledku

10

Strana od-do

1877-1886

Kód UT WoS článku

000934201700003

EID výsledku v databázi Scopus

2-s2.0-85147675867