Summary
Background
Little is known on the clinical characteristics, risk factors and outcomes during
anticoagulation in young patients with acute venous thromboembolism (VTE).
Methods
We used data from the RIETE (Registro Informatizado Enfermedad TromboEmbólica) registry
to assess the clinical characteristics, risk factors and outcomes during anticoagulation
in VTE patients aged 10–24 years. Data were separately analyzed according to initial
presentation and gender.
Results
Of 76,719 patients with VTE, 1571 (2.0%) were aged 10–24 years. Of these, 989 (63%)
were women and 669 (43%) presented with pulmonary embolism (PE). Most women were using
estrogens (680, 69%) or were pregnant (101, 10%), while 59% of men had unprovoked
VTE. Women were more likely to present with PE (48% vs. 34%). The majority (87%) of
PE patients had Sat O2 levels ≥90% at baseline. The vast majority (97%) of PE patients were at low risk
according to the PESI score, many (90%) at very low risk. During the course of anticoagulation
(median, 192 days), 40 patients had VTE recurrences, 17 had major bleeding and 10
died (3 died of PE). Women had as many VTE recurrences as major bleeds (15 vs. 14
events), while men had many more VTE recurrences than major bleeding (25 vs. 3 events).
Conclusions
VTE is associated with low risk of short-term mortality in young adults. Noticeable
gender differences exist in the risk factor profile and the risk of VTE recurrences
and major bleeding in the course of anticoagulation.
Keywords
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Article info
Publication history
Published online: March 11, 2019
Accepted:
February 10,
2019
Received in revised form:
January 31,
2019
Received:
November 9,
2018
Identification
Copyright
© 2019 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
