Influence of recent immobilization or surgery on mortality in cancer patients with venous thromboembolism
| Autor: | Monreal, M, Decousus, H, Prandoni, Paolo, Brenner, B, Barba, R, Di Micco, P, Bertoletti, L, Schellong, S, Papadakis, M, Tzoran, I, Reis, A, Bosevski, M, Bounameaux, H, Malý, R, Adarraga, Md, Arcelus, Ji, Ballaz, A, Barrón, M, Barrón Andrés, B, Bascuñana, J, Blanco Molina, A, Bueso, T, Casado, I, Castejón, N, Conget, F, del Molino, F, del Toro, J, Falgá, C, Fernández Capitán, C, Font, L, Fuentes, Mi, Gallego, P, García Bragado, F, García Lorenzo MD, Gómez, V, González, J, González Bachs, E, Grau, E, Guil, M, Gutiérrez, J, Hernández, L, Hernández Huerta, S, Jaras, Mj, Jiménez, D, Lecumberri, R, Lobo, Jl, López Jiménez, L, López Montes, L, López Reyes, R, López Sáez JB, Lorente, Ma, Lorenzo, A, Luque, Jm, Madridano, O, Marchena, Pj, Martín, M, Nauffal, D, Nieto, Ja, Núñez, Mj, Ogea, Jl, Pedrajas, Jm, Peris, Ml, Porras, Ja, Riera Mestre, A, Rivas, A, Rodríguez Dávila MA, Román, P, Roncero, A, Rosa, V, Ruiz Giménez, N, Ruiz, J, Sahuquillo, Jc, Samperiz, A, Sánchez Muñoz Torrero JF, Soler, S, Suriñach, Jm, Tiberio, G, Tolosa, C, Trujillo Santos, J, Uresandi, F, Valdés, M, Valero, B, Valle, R, Vela, J, Vidal, G, Villalta, J, Verhamme, P, Peerlinck, K, Gadelha, T, Ribeiro, R, Vassalo, J, Wells, P, Hirmerova, J, Kaletova, M, Tomko, T, Bura Riviere, A, Farge Bancel, D, Hij, A, Mahe, I, Merah, A, Babalis, D, Tzinieris, I, Braester, A, Zeltser, D, Amitrano, M, Barillari, G, Ciammaichella, M, Duce, R, Giorgi Pierfranceschi, M, Maida, R, Prandoni, P, Quintavalla, R, Rocci, A, Rota, L, Tiraferri, E, Tonello, D, Tufano, A, Visonà, A, Zalunardo, B, Sá Bastos, M, Sousa, Ms, Rei, R, Kovacevic, D, Mazzolai, L. |
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| Jazyk: | angličtina |
| Rok vydání: | 2014 |
| Předmět: |
Male
medicine.medical_specialty Multivariate analysis Hemorrhage Immobilization Neoplasms medicine Humans In patient Registries Aged Aged 80 and over business.industry Mortality rate Anticoagulants Cancer Venous Thromboembolism Hematology Odds ratio Middle Aged medicine.disease Pulmonary embolism Surgery Increased risk Multivariate Analysis Female Pulmonary Embolism business Venous thromboembolism |
| Popis: | Background: The influence of recent immobilization or surgery on mortality in cancer patients with venous thromboembolism (VTE) has not been thoroughly studied. Methods: We used the RIETE Registry data to compare the 3-month mortality rate in cancer patients with VTE, with patients categorized according to the presence of recent immobilization, surgery or neither. The major outcomes were fatal pulmonary embolism (PE) and fatal bleeding within the first 3 months. Results: Of 6,746 patients with active cancer and acute VTE, 1,224 (18%) had recent immobilization, 1,055 (16%) recent surgery, and 4,467 (66%) had neither. The all-cause mortality was 23.4% (95% CI: 22.4-24.5), and the PE-related mortality: 2.5% (95% CI: 2.1-2.9). Four in every ten patients dying of PE had recent immobilization (37%) or surgery (5.4%). Only 28% of patients with immobilization had received prophylaxis, as compared with 67% of the surgical. Fatal PE was more common in patients with recent immobilization (5.0%; 95% CI: 3.9-6.3) than in those with surgery (0.8%; 95% CI: 0.4-1.6) or neither (2.2%; 95% CI: 1.8-2.6). On multivariate analysis, patients with immobilization were at an increased risk for fatal PE (odds ratio: 1.8; 95% CI: 1.2-2.5). Conclusions: One in every three cancer patients dying of PE had recent immobilization for ≥4 days. Many of these deaths could have been prevented with adequate thromboprophylaxis. |
| Databáze: | OpenAIRE |
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