DVT Management and Outcome Trends, 2001 to 2014

Raquel Morillo; David Jiménez; Miguel Ángel Aibar; Daniela Mastroiacovo; Philip S. Wells; Ángel Sampériz; Marta Saraiva de Sousa; Alfonso Muriel; Roger D. Yusen; Manuel Monreal; Hervè Decousus; Paolo Prandoni; Benjamin Brenner; Raquel Barba; Pierpaolo Di Micco; Laurent Bertoletti; Sebastian Schellong; Inna Tzoran; Abilio Reis; Marijan Bosevski; Henri Bounameaux; Radovan Malý; Philip Wells; Manolis Papadakis; P. Agudo; M. Akasbi; M. Alcalde-Manero; V. Andújar; J. I. Arcelus; A. Ballaz; M. Barrón; B. Barrón-Andrés; J. Bascuñana; A. Blanco-Molina; I. Cañas; I. Casado; J. de Miguel; J. del Toro; S. Díaz; J. A. Díaz-Peromingo; C. Falgá; C. Fernández-Capitán; C. Font; L. Font; P. Gallego; F. García-Bragado; M. García-Rodenas; V. Gómez; C. J. González; E. Grau; L. Guirado; J. Gutiérrez; G. Hernández; L. Hernández-Blasco; V. Isern; L. Jara-Palomares; M. J. Jaras; J. L. Lobo; L. López-Jiménez; R. López-Reyes; J. B. López-Sáez; M. A. Lorente; A. Lorenzo; O. Madridano; A. Maestre; P. J. Marchena; M. Martín; J. M. Martín-Antorán; F. Martín-Martos; M. V. Morales; D. Nauffal; J. A. Nieto; S. Nieto; M. J. Núñez; C. Orbegoso; S. Otalora; R. Otero; B. Pagán; J. M. Pedrajas; C. Pérez; G. Pérez; M. L. Peris; I. Pons; J. A. Porras; O. Reig; A. Riera-Mestre; A. Rivas; C. Rodríguez; M. A. Rodríguez-Dávila; V. Rosa; A. S. Rosa-Murillo; N. Ruiz-Giménez; J. C. Sahuquillo; M. C. Sala; R. Sánchez; O. Sanz; S. Soler; J. M. Suriñach; C. Tolosa; J. Trujillo-Santos; F. Uresandi; B. Valero; R. Valle; J. Vela; G. Vidal; C. Vilar; J. Villalta; B. Xifre; T. Vanassche; P. Verhamme; J. Hirmerova; T. Tomko; G. Celis; E. Salgado; G. T. Sánchez; A. Bura-Riviere; D. Farge-Bancel; A. Hij; I. Mahé; A. Merah; I. Quere; A. Braester; A. Apollonio; G. Barillari; A. Bertone; F. Bilora; E. Bucherini; M. Ciammaichella; P. De Ciantis; F. Dentali; R. Duce; P. Ferrazzi; E. Grandone; G. Lessiani; C. Lodigiani; F. Pace; R. Pesavento; M. Pinelli; R. Poggio; M. Rosa; L. Rota; E. Tiraferri; D. Tonello; A. Tufano; U. Venturelli; A. Visonà; B. Zalunardo; E. Drucka; D. Kigitovica; A. Skride; A. Mafalda; J. L. Ribeiro; M. S. Sousa; M. Zdraveska; L. Mazzolai

doi:10.1016/j.chest.2016.03.046

DVT Management and Outcome Trends, 2001 to 2014

Raquel Morillo, David Jiménez, Miguel Ángel Aibar, Daniela Mastroiacovo, Philip S. Wells, Ángel Sampériz, Marta Saraiva de Sousa, Alfonso Muriel, Roger D. Yusen, Manuel Monreal, Hervè Decousus, Paolo Prandoni, Benjamin Brenner, Raquel Barba, Pierpaolo Di Micco, Laurent Bertoletti, Sebastian Schellong, Inna Tzoran, Abilio Reis, Marijan BosevskiHenri Bounameaux, Radovan Malý, Philip Wells, Manolis Papadakis, P. Agudo, M. Akasbi, M. Alcalde-Manero, V. Andújar, J. I. Arcelus, A. Ballaz, M. Barrón, B. Barrón-Andrés, J. Bascuñana, A. Blanco-Molina, I. Cañas, I. Casado, J. de Miguel, J. del Toro, S. Díaz, J. A. Díaz-Peromingo, C. Falgá, C. Fernández-Capitán, C. Font, L. Font, P. Gallego, F. García-Bragado, M. García-Rodenas, V. Gómez, C. J. González, E. Grau, L. Guirado, J. Gutiérrez, G. Hernández, L. Hernández-Blasco, V. Isern, L. Jara-Palomares, M. J. Jaras, J. L. Lobo, L. López-Jiménez, R. López-Reyes, J. B. López-Sáez, M. A. Lorente, A. Lorenzo, O. Madridano, A. Maestre, P. J. Marchena, M. Martín, J. M. Martín-Antorán, F. Martín-Martos, M. V. Morales, D. Nauffal, J. A. Nieto, S. Nieto, M. J. Núñez, C. Orbegoso, S. Otalora, R. Otero, B. Pagán, J. M. Pedrajas, C. Pérez, G. Pérez, M. L. Peris, I. Pons, J. A. Porras, O. Reig, A. Riera-Mestre, A. Rivas, C. Rodríguez, M. A. Rodríguez-Dávila, V. Rosa, A. S. Rosa-Murillo, N. Ruiz-Giménez, J. C. Sahuquillo, M. C. Sala, R. Sánchez, O. Sanz, S. Soler, J. M. Suriñach, C. Tolosa, J. Trujillo-Santos, F. Uresandi, B. Valero, R. Valle, J. Vela, G. Vidal, C. Vilar, J. Villalta, B. Xifre, T. Vanassche, P. Verhamme, J. Hirmerova, T. Tomko, G. Celis, E. Salgado, G. T. Sánchez, A. Bura-Riviere, D. Farge-Bancel, A. Hij, I. Mahé, A. Merah, I. Quere, A. Braester, A. Apollonio, G. Barillari, A. Bertone, F. Bilora, E. Bucherini, M. Ciammaichella, P. De Ciantis, F. Dentali, R. Duce, P. Ferrazzi, E. Grandone, G. Lessiani, C. Lodigiani, F. Pace, R. Pesavento, M. Pinelli, R. Poggio, M. Rosa, L. Rota, E. Tiraferri, D. Tonello, A. Tufano, U. Venturelli, A. Visonà, B. Zalunardo, E. Drucka, D. Kigitovica, A. Skride, A. Mafalda, J. L. Ribeiro, M. S. Sousa, M. Zdraveska, L. Mazzolai

Bar-Ilan University - Azrieli Faculty of Medicine

Research output: Contribution to journal › Article › peer-review

24 Scopus citations

Abstract

Background A comprehensive evaluation of temporal trends in the treatment of patients who have DVT may assist with identification of modifiable factors that contribute to short-term outcomes. Methods We assessed temporal trends in length of hospital stay and use of pharmacological and interventional therapies among 26,695 adults with DVT enrolled in the Registro Informatizado de la Enfermedad TromboEmbólica registry between 2001 and 2014. We also examined temporal trends in risk-adjusted rates of all-cause, pulmonary embolism-related, and bleeding-related death to 30 days after diagnosis. Results The mean length of hospital stay decreased from 9.0 days in 2001 to 2005 to 7.6 days in 2010 to 2014 (P <01). For initial DVT treatment, the use of low-molecular-weight heparin decreased from 98% to 90% (P <01). Direct oral anticoagulants use increased from 0.5% in 2010 to 13.4% in 2014 (P <001). Risk-adjusted rates of 30-day all-cause mortality decreased from 3.9% in 2001 to 2005 to 2.7% in 2010 to 2014 (adjusted rate ratio per year, 0.84; 95% CI, 0.74-0.96; P <01). VTE-related mortality showed a nonstatistically significant downward trend (adjusted rate ratio per year, 0.70; 95% CI, 0.44-1.10; P =13), whereas 30-day bleeding-related mortality significantly decreased from 0.5% in 2001 to 2005 to 0.1% in 2010-2014 (adjusted rate ratio per year, 0.55; 95% CI, 0.40-0.77; P < .01). Conclusions This international registry-based temporal analysis identified reductions in length of stay for adults hospitalized for DVT. The study also found a decreasing trend in adjusted rates of all-cause and bleeding-related mortality.

Original language	English
Pages (from-to)	374-383
Number of pages	10
Journal	Chest
Volume	150
Issue number	2
DOIs	https://doi.org/10.1016/j.chest.2016.03.046
State	Published - 1 Aug 2016

Bibliographical note

Publisher Copyright:
© 2016 American College of Chest Physicians

Funding

Financial/nonfinancial disclosures: The authors have reported to CHEST the following: D. J. has served as an advisor or consultant for Bayer HealthCare Pharmaceuticals, Boehringer Ingelheim, Bristol-Myers Squibb, Daiichi Sankyo, Leo Pharma, Pfizer, ROVI, and Sanofi; served as a speaker or a member of a speakers’ bureau for Bayer HealthCare Pharmaceuticals, Boehringer Ingelheim, Bristol-Myers Squibb, Daiichi Sankyo, Leo Pharma, ROVI, and Sanofi; received grants for clinical research from Sanofi and ROVI. P. W. has served as an advisor or consultant for Bayer HealthCare Pharmaceuticals, Bristol-Myers Squibb, and Daiichi Sankyo. R. Y. has received research funding from Bayer HealthCare Pharmaceuticals, Inc., Portola, Inc., Pfizer, Inc., and Bristol-Meyers Squibb in the past 3 years. He has served as a consultant for Bayer HealthCare, Inc., Bristol-Meyers Squibb Glaxo SmithKline, Janssen, Johnson & Johnson, Ortho Pharmaceuticals, Inc., Organon, Inc., Pfizer, Inc., Portola, Inc., Sanofi-Aventis, and SCIOS, Inc, in the past 3 years. M. M. has served as an advisor or consultant for Bayer HealthCare Pharmaceuticals, Boehringer Ingelheim, Leo Pharma, Pfizer, and Sanofi; served as a speaker or a member of a speakers’ bureau for Bayer HealthCare Pharmaceuticals, Daiichi Sankyo, Leo Pharma, and Sanofi; and received grants for clinical research from Sanofi and Bayer. None declared (R. M., M. A. A., D. M., A. S., M. S. d. S., A. M.).

Funders	Funder number
Bayer HealthCare Pharmaceuticals, Inc., Portola, Inc.
Pfizer

Keywords

DVT
prognosis
survival

Access to Document

10.1016/j.chest.2016.03.046

Cite this

Morillo, R., Jiménez, D., Aibar, M. Á., Mastroiacovo, D., Wells, P. S., Sampériz, Á., Saraiva de Sousa, M., Muriel, A., Yusen, R. D., Monreal, M., Decousus, H., Prandoni, P., Brenner, B., Barba, R., Di Micco, P., Bertoletti, L., Schellong, S., Tzoran, I., Reis, A., ... Mazzolai, L. (2016). DVT Management and Outcome Trends, 2001 to 2014. Chest, 150(2), 374-383. https://doi.org/10.1016/j.chest.2016.03.046

@article{558f99f12e814b9c9671deab7d413f32,

title = "DVT Management and Outcome Trends, 2001 to 2014",

abstract = "Background A comprehensive evaluation of temporal trends in the treatment of patients who have DVT may assist with identification of modifiable factors that contribute to short-term outcomes. Methods We assessed temporal trends in length of hospital stay and use of pharmacological and interventional therapies among 26,695 adults with DVT enrolled in the Registro Informatizado de la Enfermedad TromboEmb{\'o}lica registry between 2001 and 2014. We also examined temporal trends in risk-adjusted rates of all-cause, pulmonary embolism-related, and bleeding-related death to 30 days after diagnosis. Results The mean length of hospital stay decreased from 9.0 days in 2001 to 2005 to 7.6 days in 2010 to 2014 (P <01). For initial DVT treatment, the use of low-molecular-weight heparin decreased from 98% to 90% (P <01). Direct oral anticoagulants use increased from 0.5% in 2010 to 13.4% in 2014 (P <001). Risk-adjusted rates of 30-day all-cause mortality decreased from 3.9% in 2001 to 2005 to 2.7% in 2010 to 2014 (adjusted rate ratio per year, 0.84; 95% CI, 0.74-0.96; P <01). VTE-related mortality showed a nonstatistically significant downward trend (adjusted rate ratio per year, 0.70; 95% CI, 0.44-1.10; P =13), whereas 30-day bleeding-related mortality significantly decreased from 0.5% in 2001 to 2005 to 0.1% in 2010-2014 (adjusted rate ratio per year, 0.55; 95% CI, 0.40-0.77; P < .01). Conclusions This international registry-based temporal analysis identified reductions in length of stay for adults hospitalized for DVT. The study also found a decreasing trend in adjusted rates of all-cause and bleeding-related mortality.",

keywords = "DVT, prognosis, survival",

author = "Raquel Morillo and David Jim{\'e}nez and Aibar, {Miguel {\'A}ngel} and Daniela Mastroiacovo and Wells, {Philip S.} and {\'A}ngel Samp{\'e}riz and {Saraiva de Sousa}, Marta and Alfonso Muriel and Yusen, {Roger D.} and Manuel Monreal and Herv{\`e} Decousus and Paolo Prandoni and Benjamin Brenner and Raquel Barba and {Di Micco}, Pierpaolo and Laurent Bertoletti and Sebastian Schellong and Inna Tzoran and Abilio Reis and Marijan Bosevski and Henri Bounameaux and Radovan Mal{\'y} and Philip Wells and Manolis Papadakis and P. Agudo and M. Akasbi and M. Alcalde-Manero and V. And{\'u}jar and Arcelus, {J. I.} and A. Ballaz and M. Barr{\'o}n and B. Barr{\'o}n-Andr{\'e}s and J. Bascu{\~n}ana and A. Blanco-Molina and I. Ca{\~n}as and I. Casado and {de Miguel}, J. and {del Toro}, J. and S. D{\'i}az and D{\'i}az-Peromingo, {J. A.} and C. Falg{\'a} and C. Fern{\'a}ndez-Capit{\'a}n and C. Font and L. Font and P. Gallego and F. Garc{\'i}a-Bragado and M. Garc{\'i}a-Rodenas and V. G{\'o}mez and Gonz{\'a}lez, {C. J.} and E. Grau and L. Guirado and J. Guti{\'e}rrez and G. Hern{\'a}ndez and L. Hern{\'a}ndez-Blasco and V. Isern and L. Jara-Palomares and Jaras, {M. J.} and Lobo, {J. L.} and L. L{\'o}pez-Jim{\'e}nez and R. L{\'o}pez-Reyes and L{\'o}pez-S{\'a}ez, {J. B.} and Lorente, {M. A.} and A. Lorenzo and O. Madridano and A. Maestre and Marchena, {P. J.} and M. Mart{\'i}n and Mart{\'i}n-Antor{\'a}n, {J. M.} and F. Mart{\'i}n-Martos and Morales, {M. V.} and D. Nauffal and Nieto, {J. A.} and S. Nieto and N{\'u}{\~n}ez, {M. J.} and C. Orbegoso and S. Otalora and R. Otero and B. Pag{\'a}n and Pedrajas, {J. M.} and C. P{\'e}rez and G. P{\'e}rez and Peris, {M. L.} and I. Pons and Porras, {J. A.} and O. Reig and A. Riera-Mestre and A. Rivas and C. Rodr{\'i}guez and Rodr{\'i}guez-D{\'a}vila, {M. A.} and V. Rosa and Rosa-Murillo, {A. S.} and N. Ruiz-Gim{\'e}nez and Sahuquillo, {J. C.} and Sala, {M. C.} and R. S{\'a}nchez and O. Sanz and S. Soler and Suri{\~n}ach, {J. M.} and C. Tolosa and J. Trujillo-Santos and F. Uresandi and B. Valero and R. Valle and J. Vela and G. Vidal and C. Vilar and J. Villalta and B. Xifre and T. Vanassche and P. Verhamme and J. Hirmerova and T. Tomko and G. Celis and E. Salgado and S{\'a}nchez, {G. T.} and A. Bura-Riviere and D. Farge-Bancel and A. Hij and I. Mah{\'e} and A. Merah and I. Quere and A. Braester and A. Apollonio and G. Barillari and A. Bertone and F. Bilora and E. Bucherini and M. Ciammaichella and {De Ciantis}, P. and F. Dentali and R. Duce and P. Ferrazzi and E. Grandone and G. Lessiani and C. Lodigiani and F. Pace and R. Pesavento and M. Pinelli and R. Poggio and M. Rosa and L. Rota and E. Tiraferri and D. Tonello and A. Tufano and U. Venturelli and A. Vison{\`a} and B. Zalunardo and E. Drucka and D. Kigitovica and A. Skride and A. Mafalda and Ribeiro, {J. L.} and Sousa, {M. S.} and M. Zdraveska and L. Mazzolai",

note = "Publisher Copyright: {\textcopyright} 2016 American College of Chest Physicians",

year = "2016",

month = aug,

day = "1",

doi = "10.1016/j.chest.2016.03.046",

language = "אנגלית",

volume = "150",

pages = "374--383",

journal = "Chest",

issn = "0012-3692",

publisher = "Elsevier Inc.",

number = "2",

}

Morillo, R, Jiménez, D, Aibar, MÁ, Mastroiacovo, D, Wells, PS, Sampériz, Á, Saraiva de Sousa, M, Muriel, A, Yusen, RD, Monreal, M, Decousus, H, Prandoni, P, Brenner, B, Barba, R, Di Micco, P, Bertoletti, L, Schellong, S, Tzoran, I, Reis, A, Bosevski, M, Bounameaux, H, Malý, R, Wells, P, Papadakis, M, Agudo, P, Akasbi, M, Alcalde-Manero, M, Andújar, V, Arcelus, JI, Ballaz, A, Barrón, M, Barrón-Andrés, B, Bascuñana, J, Blanco-Molina, A, Cañas, I, Casado, I, de Miguel, J, del Toro, J, Díaz, S, Díaz-Peromingo, JA, Falgá, C, Fernández-Capitán, C, Font, C, Font, L, Gallego, P, García-Bragado, F, García-Rodenas, M, Gómez, V, González, CJ, Grau, E, Guirado, L, Gutiérrez, J, Hernández, G, Hernández-Blasco, L, Isern, V, Jara-Palomares, L, Jaras, MJ, Lobo, JL, López-Jiménez, L, López-Reyes, R, López-Sáez, JB, Lorente, MA, Lorenzo, A, Madridano, O, Maestre, A, Marchena, PJ, Martín, M, Martín-Antorán, JM, Martín-Martos, F, Morales, MV, Nauffal, D, Nieto, JA, Nieto, S, Núñez, MJ, Orbegoso, C, Otalora, S, Otero, R, Pagán, B, Pedrajas, JM, Pérez, C, Pérez, G, Peris, ML, Pons, I, Porras, JA, Reig, O, Riera-Mestre, A, Rivas, A, Rodríguez, C, Rodríguez-Dávila, MA, Rosa, V, Rosa-Murillo, AS, Ruiz-Giménez, N, Sahuquillo, JC, Sala, MC, Sánchez, R, Sanz, O, Soler, S, Suriñach, JM, Tolosa, C, Trujillo-Santos, J, Uresandi, F, Valero, B, Valle, R, Vela, J, Vidal, G, Vilar, C, Villalta, J, Xifre, B, Vanassche, T, Verhamme, P, Hirmerova, J, Tomko, T, Celis, G, Salgado, E, Sánchez, GT, Bura-Riviere, A, Farge-Bancel, D, Hij, A, Mahé, I, Merah, A, Quere, I, Braester, A, Apollonio, A, Barillari, G, Bertone, A, Bilora, F, Bucherini, E, Ciammaichella, M, De Ciantis, P, Dentali, F, Duce, R, Ferrazzi, P, Grandone, E, Lessiani, G, Lodigiani, C, Pace, F, Pesavento, R, Pinelli, M, Poggio, R, Rosa, M, Rota, L, Tiraferri, E, Tonello, D, Tufano, A, Venturelli, U, Visonà, A, Zalunardo, B, Drucka, E, Kigitovica, D, Skride, A, Mafalda, A, Ribeiro, JL, Sousa, MS, Zdraveska, M & Mazzolai, L 2016, 'DVT Management and Outcome Trends, 2001 to 2014', Chest, vol. 150, no. 2, pp. 374-383. https://doi.org/10.1016/j.chest.2016.03.046

TY - JOUR

T1 - DVT Management and Outcome Trends, 2001 to 2014

AU - Morillo, Raquel

AU - Jiménez, David

AU - Aibar, Miguel Ángel

AU - Mastroiacovo, Daniela

AU - Wells, Philip S.

AU - Sampériz, Ángel

AU - Saraiva de Sousa, Marta

AU - Muriel, Alfonso

AU - Yusen, Roger D.

AU - Monreal, Manuel

AU - Decousus, Hervè

AU - Prandoni, Paolo

AU - Brenner, Benjamin

AU - Barba, Raquel

AU - Di Micco, Pierpaolo

AU - Bertoletti, Laurent

AU - Schellong, Sebastian

AU - Tzoran, Inna

AU - Reis, Abilio

AU - Bosevski, Marijan

AU - Bounameaux, Henri

AU - Malý, Radovan

AU - Wells, Philip

AU - Papadakis, Manolis

AU - Agudo, P.

AU - Akasbi, M.

AU - Alcalde-Manero, M.

AU - Andújar, V.

AU - Arcelus, J. I.

AU - Ballaz, A.

AU - Barrón, M.

AU - Barrón-Andrés, B.

AU - Bascuñana, J.

AU - Blanco-Molina, A.

AU - Cañas, I.

AU - Casado, I.

AU - de Miguel, J.

AU - del Toro, J.

AU - Díaz, S.

AU - Díaz-Peromingo, J. A.

AU - Falgá, C.

AU - Fernández-Capitán, C.

AU - Font, C.

AU - Font, L.

AU - Gallego, P.

AU - García-Bragado, F.

AU - García-Rodenas, M.

AU - Gómez, V.

AU - González, C. J.

AU - Grau, E.

AU - Guirado, L.

AU - Gutiérrez, J.

AU - Hernández, G.

AU - Hernández-Blasco, L.

AU - Isern, V.

AU - Jara-Palomares, L.

AU - Jaras, M. J.

AU - Lobo, J. L.

AU - López-Jiménez, L.

AU - López-Reyes, R.

AU - López-Sáez, J. B.

AU - Lorente, M. A.

AU - Lorenzo, A.

AU - Madridano, O.

AU - Maestre, A.

AU - Marchena, P. J.

AU - Martín, M.

AU - Martín-Antorán, J. M.

AU - Martín-Martos, F.

AU - Morales, M. V.

AU - Nauffal, D.

AU - Nieto, J. A.

AU - Nieto, S.

AU - Núñez, M. J.

AU - Orbegoso, C.

AU - Otalora, S.

AU - Otero, R.

AU - Pagán, B.

AU - Pedrajas, J. M.

AU - Pérez, C.

AU - Pérez, G.

AU - Peris, M. L.

AU - Pons, I.

AU - Porras, J. A.

AU - Reig, O.

AU - Riera-Mestre, A.

AU - Rivas, A.

AU - Rodríguez, C.

AU - Rodríguez-Dávila, M. A.

AU - Rosa, V.

AU - Rosa-Murillo, A. S.

AU - Ruiz-Giménez, N.

AU - Sahuquillo, J. C.

AU - Sala, M. C.

AU - Sánchez, R.

AU - Sanz, O.

AU - Soler, S.

AU - Suriñach, J. M.

AU - Tolosa, C.

AU - Trujillo-Santos, J.

AU - Uresandi, F.

AU - Valero, B.

AU - Valle, R.

AU - Vela, J.

AU - Vidal, G.

AU - Vilar, C.

AU - Villalta, J.

AU - Xifre, B.

AU - Vanassche, T.

AU - Verhamme, P.

AU - Hirmerova, J.

AU - Tomko, T.

AU - Celis, G.

AU - Salgado, E.

AU - Sánchez, G. T.

AU - Bura-Riviere, A.

AU - Farge-Bancel, D.

AU - Hij, A.

AU - Mahé, I.

AU - Merah, A.

AU - Quere, I.

AU - Braester, A.

AU - Apollonio, A.

AU - Barillari, G.

AU - Bertone, A.

AU - Bilora, F.

AU - Bucherini, E.

AU - Ciammaichella, M.

AU - De Ciantis, P.

AU - Dentali, F.

AU - Duce, R.

AU - Ferrazzi, P.

AU - Grandone, E.

AU - Lessiani, G.

AU - Lodigiani, C.

AU - Pace, F.

AU - Pesavento, R.

AU - Pinelli, M.

AU - Poggio, R.

AU - Rosa, M.

AU - Rota, L.

AU - Tiraferri, E.

AU - Tonello, D.

AU - Tufano, A.

AU - Venturelli, U.

AU - Visonà, A.

AU - Zalunardo, B.

AU - Drucka, E.

AU - Kigitovica, D.

AU - Skride, A.

AU - Mafalda, A.

AU - Ribeiro, J. L.

AU - Sousa, M. S.

AU - Zdraveska, M.

AU - Mazzolai, L.

PY - 2016/8/1

Y1 - 2016/8/1

N2 - Background A comprehensive evaluation of temporal trends in the treatment of patients who have DVT may assist with identification of modifiable factors that contribute to short-term outcomes. Methods We assessed temporal trends in length of hospital stay and use of pharmacological and interventional therapies among 26,695 adults with DVT enrolled in the Registro Informatizado de la Enfermedad TromboEmbólica registry between 2001 and 2014. We also examined temporal trends in risk-adjusted rates of all-cause, pulmonary embolism-related, and bleeding-related death to 30 days after diagnosis. Results The mean length of hospital stay decreased from 9.0 days in 2001 to 2005 to 7.6 days in 2010 to 2014 (P <01). For initial DVT treatment, the use of low-molecular-weight heparin decreased from 98% to 90% (P <01). Direct oral anticoagulants use increased from 0.5% in 2010 to 13.4% in 2014 (P <001). Risk-adjusted rates of 30-day all-cause mortality decreased from 3.9% in 2001 to 2005 to 2.7% in 2010 to 2014 (adjusted rate ratio per year, 0.84; 95% CI, 0.74-0.96; P <01). VTE-related mortality showed a nonstatistically significant downward trend (adjusted rate ratio per year, 0.70; 95% CI, 0.44-1.10; P =13), whereas 30-day bleeding-related mortality significantly decreased from 0.5% in 2001 to 2005 to 0.1% in 2010-2014 (adjusted rate ratio per year, 0.55; 95% CI, 0.40-0.77; P < .01). Conclusions This international registry-based temporal analysis identified reductions in length of stay for adults hospitalized for DVT. The study also found a decreasing trend in adjusted rates of all-cause and bleeding-related mortality.

AB - Background A comprehensive evaluation of temporal trends in the treatment of patients who have DVT may assist with identification of modifiable factors that contribute to short-term outcomes. Methods We assessed temporal trends in length of hospital stay and use of pharmacological and interventional therapies among 26,695 adults with DVT enrolled in the Registro Informatizado de la Enfermedad TromboEmbólica registry between 2001 and 2014. We also examined temporal trends in risk-adjusted rates of all-cause, pulmonary embolism-related, and bleeding-related death to 30 days after diagnosis. Results The mean length of hospital stay decreased from 9.0 days in 2001 to 2005 to 7.6 days in 2010 to 2014 (P <01). For initial DVT treatment, the use of low-molecular-weight heparin decreased from 98% to 90% (P <01). Direct oral anticoagulants use increased from 0.5% in 2010 to 13.4% in 2014 (P <001). Risk-adjusted rates of 30-day all-cause mortality decreased from 3.9% in 2001 to 2005 to 2.7% in 2010 to 2014 (adjusted rate ratio per year, 0.84; 95% CI, 0.74-0.96; P <01). VTE-related mortality showed a nonstatistically significant downward trend (adjusted rate ratio per year, 0.70; 95% CI, 0.44-1.10; P =13), whereas 30-day bleeding-related mortality significantly decreased from 0.5% in 2001 to 2005 to 0.1% in 2010-2014 (adjusted rate ratio per year, 0.55; 95% CI, 0.40-0.77; P < .01). Conclusions This international registry-based temporal analysis identified reductions in length of stay for adults hospitalized for DVT. The study also found a decreasing trend in adjusted rates of all-cause and bleeding-related mortality.

KW - DVT

KW - prognosis

KW - survival

UR - http://www.scopus.com/inward/record.url?scp=84981266568&partnerID=8YFLogxK

U2 - 10.1016/j.chest.2016.03.046

DO - 10.1016/j.chest.2016.03.046

M3 - ???researchoutput.researchoutputtypes.contributiontojournal.article???

C2 - 27071810

AN - SCOPUS:84981266568

SN - 0012-3692

VL - 150

SP - 374

EP - 383

JO - Chest

JF - Chest

IS - 2

ER -