Retrospective evaluation of venous thromboembolism: Are all transient provoking events the same?
Autor: | Chong Chyn Chua, Hui Yin Lim, Harshal Hanumant Nandurkar, Prahlad Ho, Mark Tacey |
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Rok vydání: | 2017 |
Předmět: |
Male
medicine.medical_specialty 030204 cardiovascular system & hematology Lower risk Risk Assessment 03 medical and health sciences 0302 clinical medicine Recurrence Risk Factors Single entity Internal medicine medicine Humans cardiovascular diseases Mortality Aged Retrospective Studies Air travel Aged 80 and over business.industry Incidence Australia Disease Management Venous Thromboembolism Hematology General Medicine Middle Aged Surgery Relative risk Female Provoking factor business Venous thromboembolism High recurrence rate Follow-Up Studies 030215 immunology |
Zdroj: | European Journal of Haematology. 99:18-26 |
ISSN: | 0902-4441 |
Popis: | Objectives Venous thromboembolism (VTE) provoked by transient risk factors has traditionally been classified as a single entity with lower risk of recurrence. We evaluated the association between different categories of transient provoking factors and the relative risk of recurrence. Methods Retrospective evaluation of VTE events in non-cancer patients from July 2011 to December 2012 at two tertiary institutions in Australia with a minimum follow-up of 24 months. Results A total of 747 VTE cases were identified, and following exclusion of cases with mortality within 30 days of presentation (n=26), unprovoked cases (40.2%) had a higher risk of recurrence (4.6 vs 2.3/100 event-years, P=.01). Provoking factors included surgery (40.4%), injury (16.7%), medical-related factors including non-surgical hospitalisation or active infection (22.0%), travel (13.2%) and oestrogen related (6.5%). Air travel had the highest recurrence rate of 5.9/100 event-years, comparable to unprovoked VTE. VTE provoked by surgery showed lower recurrence rate at 1.8/100 event-years (P=.03). 62.5% of patients with provoked VTE recurred with an unprovoked event. Conclusion Transient provoking factors for VTE are heterogeneous with varying potency and should not be considered a single entity. The high recurrence rate after travel-provoked VTE suggests that it is a “minor,” if not negligible provoking factor with higher thrombotic predisposition. |
Databáze: | OpenAIRE |
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