Highlights
- •Thromboprophylaxis decreases the VTE risk.
- •Patients may present VTE despite prevention.
- •Their prognosis is not worse than the others.
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 3 months 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
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Article info
Publication history
Published online: March 11, 2016
Accepted:
February 23,
2016
Received in revised form:
February 22,
2016
Received:
January 6,
2016
Identification
Copyright
© 2016 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
