Predictors of in-hospital mortality in elderly patients with acute venous thrombo-embolism: the SWIss Venous ThromboEmbolism Registry (SWIVTER)

Spirk, David; Husmann, Marc; Hayoz, Daniel; Baldi, Thomas; Frauchiger, Beat; Engelberger, Rolf P.; Amann-Vesti, Beatrice; Baumgartner, Iris; Kucher, Nils

doi:10.1093/eurheartj/ehr392

Cited by 48 publications

(45 citation statements)

References 14 publications

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“…22,[31][32][33][34] In TUSCAN-PE recent infectious diseases, especially affecting the respiratory system, were found as the main risk factors of PE. Despite this percentage is much greater compared to the most recently published studies on topic, 10,11,14,17 this finding is not completely surprising, since than in the recent years many literature reports have focused on link between infectious diseases, inflammation and thrombosis. 35,36 Further investigations are warranted to better define the role of infectious diseases as risk factors for PE.…”

Section: Discussionmentioning

confidence: 83%

“…Immobility remains one of the most frequent risk factors for VTE, especially in elderly patients and our study confirms it in agreement with literature. [9][10][11][12][13][14]17,28 In TUSCAN-PE around one third of patients discharged with PE from Internal Medicine wards has active cancer. This finding is higher compared to the most [ Management of acute pulmonary embolism recent studies, such as IPER, EMPEROR, MASTER, SWIVTER and ZATPOL, but similar to that observed in the Italian population of RIETE registry.…”

Section: Discussionmentioning

confidence: 99%

“…[6][7][8][9][10][11][12] Furthermore other studies or registries such as MASTER, RIETE and the ongoing SCOPE, despite enclosing Italian Internal Medicine Units, were conducted in Centers of recognized experience in the field of venous thromboembolism, whereas other studies such as ZATPOL and SWIVTER were conducted in European countries out of Italy. [13][14][15][16][17] Practical recommendations on prevention, diagnosis, prognostic stratification and acute treatment have had wide diffusion in the last years [18][19][20][21] but evidence about their application in real life lack. Therefore the aim of our study was to provide information about characteristics and clinical management of acute PE patients admitted in the setting of Italian Internal Medicine wards.…”

Section: Introductionmentioning

confidence: 99%

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Characteristics and clinical management of acute pulmonary embolism in real world: findings from TUSCAN-PE Study

Masotti

Pieralli

Panigada³

et al. 2014

Ital J Med

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Acute pulmonary embolism (PE) remains one of the leading causes of mortality and morbidity in cardiovascular setting. Despite much information about clinical aspects and recommendations or clinical guidelines is available from literature, few data exist about the management of PE in real world of internal medicine scenario. Therefore the aim of the present study was to report on characteristics and management of PE patients admitted in this setting. TUSCAN-PE study was a multicenter, observational, retrospective, cohort study aimed to analyze data of PE patients admitted in Internal Medicine wards of Tuscany. Each center was invited to submit anonymously data of at least ten patients consecutively discharged for acute PE in 2012. Data were referred to demographic, clinical, instrumental, prognostic and therapeutic characteristics. A total of 452 patients from 28 Tuscan centers (60.2% F), with mean age 76.01±12.34 years, were enrolled. A total of 87% of patients was admitted from Emergency Department, but only 65.2% of patients with diagnosis of PE. Around one third of diagnoses of PE was performed by internists. In 14.8% of diagnoses was incidental. In 86% of patients, diagnosis was performed by computer tomography pulmonary angiography. Overall mortality was 9.5%, 5.75% being PE-related. Main risk factors enclosed recent respiratory tract infections (55.3%), immobility (42.25%), recent hospital admissions (33.6%) and cancer (30.3%). In 65.8% of patients, PE was associated with deep vein thrombosis. 16.6% of patients had a shock index ≥1 and 84.75% simplified pulmonary embolism severity index (PESI) score ≥1. A number of 51.5% of patients presented echocardiographic right heart dysfunction, 50.6% and 55.9% of patients presented increased values of troponins and natriuretic peptides, respectively. The following percentage, 6.5%, 71.1% and 22.4%, were defined as high, intermediate and low risk according to the European Society of Cardiology (ESC) criteria, respectively. Antithrombotic treatment was started in Internal Medicine wards in 60.6% of patients. 4.9% of patients were treated with systemic thrombolysis, 15.1% with intravenous unfractionated heparin, whereas low molecular weight heparins and fondaparinux were performed in 39.2% and 39.8% of patients, respectively. Vitamin K antagonists were prescribed in 52.1% of patients at hospital discharge. Fatal and non-fatal major bleedings occurred in 1.7% of patients. TUSCAN-PE study contributes to the knowledge of real life management of acute PE in the Internal Medicine setting.

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Section: Discussionmentioning

confidence: 83%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Characteristics and clinical management of acute pulmonary embolism in real world: findings from TUSCAN-PE Study

Masotti

Pieralli

Panigada³

et al. 2014

Ital J Med

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“…8 Although thrombolysis is the mainstay of therapy in high-risk PE; it was reported that bleeding complication of TT is high. 9 Additionaly, since it might result with unsuccessful thrombolysis, rescue surgical pulmonary embolectomy might be a life-saving strategy. In a prospective single-center registry of 488 patients with massive PE, it was shown that rescue surgical embolectomy (n=14) led to a better in-hospital course when compared with repeat thrombolysis (n=26) in those who have not responded to thrombolysis.…”

Section: Discussionmentioning

confidence: 99%

Rescue Surgical Embolectomy in Acute Massive Pulmonary Embolism Presenting with Supraventricular Tachycardia

Dursunoğlu¹,

Dursunoğlu²,

Uğurlu³

et al. 2017

Turkiye Klinikleri J Med Sci

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“…Although elderly patients have more severe venous thromboembolism (VTE) and a higher short-term mortality rate than younger patients [7,8], the prognostic performance of TTE to predict mortality has not been specifically examined in elderly patients with acute PE. The aim of this study was to prospectively evaluate the prevalence of common echocardiographic signs of RV dysfunction and their prognostic impact in elderly patients with acute PE.…”

Section: Introductionmentioning

confidence: 99%

Echocardiography does not predict mortality in hemodynamically stable elderly patients with acute pulmonary embolism

Hofmann

Limacher

Méan

et al. 2016

Thrombosis Research

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Predictors of in-hospital mortality in elderly patients with acute venous thrombo-embolism: the SWIss Venous ThromboEmbolism Registry (SWIVTER)

Abstract: Elderly patients had more serious VTE than younger patients, and massive PE was particularly life-threatening in the elderly.

Cited by 48 publications

References 14 publications

Characteristics and clinical management of acute pulmonary embolism in real world: findings from TUSCAN-PE Study

Characteristics and clinical management of acute pulmonary embolism in real world: findings from TUSCAN-PE Study

Rescue Surgical Embolectomy in Acute Massive Pulmonary Embolism Presenting with Supraventricular Tachycardia

Echocardiography does not predict mortality in hemodynamically stable elderly patients with acute pulmonary embolism

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