Format

Send to

Choose Destination
Eur J Intern Med. 2016 May;30:72-76. doi: 10.1016/j.ejim.2016.02.022. Epub 2016 Mar 11.

Prior thromboprophylaxis and outcome in patients experiencing acute venous thromboembolism after an acute medical illness.

Author information

1
INSERM, CIC1408, Saint-Etienne F-42055, France; INSERM, UMR1059, Equipe Dysfonction Vasculaire et Hémostase, Université Jean-Monnet, Saint-Etienne F-42055, France; CHU Saint-Etienne, Service de Médecine Vasculaire et Thérapeutique, Saint-Etienne F-42055, France; GIRC-Thrombose-INNOVTE network, Hôpital Nord, CHU de Saint-Etienne, Saint-Etienne F-42055, France. Electronic address: adel.merah@chu-st-etienne.fr.
2
INSERM, CIC1408, Saint-Etienne F-42055, France; INSERM, UMR1059, Equipe Dysfonction Vasculaire et Hémostase, Université Jean-Monnet, Saint-Etienne F-42055, France; CHU Saint-Etienne, Service de Médecine Vasculaire et Thérapeutique, Saint-Etienne F-42055, France; GIRC-Thrombose-INNOVTE network, Hôpital Nord, CHU de Saint-Etienne, Saint-Etienne F-42055, France.
3
INSERM, CIC1408, Saint-Etienne F-42055, France; CHU Saint-Etienne, Service de Médecine Vasculaire et Thérapeutique, Saint-Etienne F-42055, France.
4
Department of Internal Medicine, Tel Aviv Soursky Medical Center, Tel Aviv, Israel.
5
Department of Pneumonology, Hospital San Pedro, Logroño, La Rioja, Spain.
6
Department of Internal Medicine, Hospital General de Granollers, Barcelona, Spain.
7
Department of Internal Medicine, Hospital Clinic, Barcelona, Spain.
8
Department of Vascular Medicine, Azienda U.S.L. Di Ravenna-O.C. Di Faenza, Ravenna, Italy.
9
Department of Internal Medicine, Hospital Universitario Germans Trias i Pujol de Badalona, Universidad Católica de Murcia, Spain.

Abstract

BACKGROUND:

Even despite the use of thromboprophylaxis, some patients with an acute medical illness develop symptomatic venous thromboembolism (VTE). It is unclear whether the outcome in these patients is different in those in whom prophylaxis was not prescribed.

PATIENTS AND METHODS:

We used the RIETE (Registro Informatizado Enfermedad TromboEmbolica) database to compare the 3-month outcome (death, fatal pulmonary embolism, VTE recurrences, major bleeding) of patients with acute VTE after immobilization for an acute medical disease, according to the use of prophylaxis.

RESULTS:

Thromboprophylaxis was prescribed in 1313 (37%) of the 3527 patients included in August 2014. Acute infection was the most frequent cause of immobilization. Patients who received prophylaxis were more frequently immobilized in hospital than at home (70% vs. 22%), and fewer patients were immobilized for cancer (13% vs. 22%). During the first 3months of treatment, the rates of all-cause death (23 vs. 21%), fatal PE (2.6 vs. 3.1%), VTE recurrences (2.4% vs. 2.8%), and major bleeding (4.2% for both) did not differ between the two groups. Thromboprophylaxis was not associated with each outcome in multivariate analysis.

CONCLUSIONS:

The outcome in patients with VTE provoked by medical immobilization was not influenced by the use of thromboprophylaxis during the period of immobility.

KEYWORDS:

Anticoagulation; Outcome; Thromboprophylaxis; Venous thromboembolism

PMID:
26975476
DOI:
10.1016/j.ejim.2016.02.022
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center