Age-Related Differences in the Presentation, Management, and Clinical Outcomes of 100,000 Patients With Venous Thromboembolism in the RIETE Registry.

Fecha de publicación: 01/03/2024 Fecha Ahead of Print: 03/01/2024

Autores de IIS La Fe

Alberto García Ortega

Autor

Participantes ajenos a IIS La Fe

Jiménez D
Pedro-Tudela A
Pérez-Ductor C
Fernández-Capitán C
Falgá C
Skride A
Siniscalchi C
Weinberg I
Monreal M
RIETE investigators

Grupos

Neumología

Leader

Miguel Ángel Martínez García

Abstract

INTRODUCTION: Although older adults represent a significant proportion of patients with venous thromboembolism (VTE), the data on the impact of age-related differences in the clinical presentation, management, and outcomes of VTE are scarce. METHODS: We analyzed data from the RIETE registry database, an ongoing global observational registry of patients with objectively confirmed VTE, to compare patient characteristics, clinical presentation, treatments, and outcomes between elderly (=70 years) vs. non-elderly (<70 years) patients. RESULTS: From January 2001 to March 2021, 100,000 adult patients were enrolled in RIETE. Elderly patients (47.9%) were more frequently women (58.2% vs. 43.5%), more likely had unprovoked VTE (50.5% vs. 45.1%) and most often presented with severe renal failure (10.2% vs. 1.2%) and acute pulmonary embolism (PE) (vs. deep vein thrombosis) (54.3% vs. 44.5%) compared to non-elderly patients (p<0.001 for all comparisons). For the PE subgroup, elderly patients more frequently had non-low risk PE (78.9% vs. 50.7%; p<0.001), respiratory failure (33.9% vs. 21.8%; p<0.001) and myocardial injury (40.0% vs. 26.2%; p<0.001) compared to non-elderly patients. Thrombolysis (0.9% vs. 1.7%; p<0.001) and direct oral anticoagulants (8.8% vs. 11.8%; p<0.001) were less frequently administered to elderly patients. Elderly patients showed a significantly higher 30-day all-cause mortality (adjusted odds ratio [OR] 1.36, 95%CI: 1.22-1.52) and major bleeding (OR, 2.08; 95%CI, 1.85-2.33), but a lower risk of 30-day VTE recurrences (OR, 0.62, 95%CI, 0.54-0.71). CONCLUSIONS: Compared with non-elderly patients, elderly patients had a different VTE clinical profile. Advanced therapies were less frequently used in older patients. Age was an independent predictor of mortality.

Datos de la publicación

ISSN/ISSNe:: 0300-2896, 1579-2129
Tipo:: Article
Páginas:: 143-152
DOI:: 10.1016/j.arbres.2023.12.016
PubMed:: 38220587
Factor de Impacto:: 0,262 SCImago ℠
Cuartil:: Q3 SCImago ℠

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Métricas

Filiaciones

Ortega AG:: Respiratory Department, Hospital Dr. Peset, Valencia, Spain

Instituto de Investigación. Medical Research Institute Hospital La Fe (IISLAFE), Valencia, Spain
Jiménez D:: Respiratory Department, Hospital Ramón y Cajal, Universidad de Alcalá (IRYCIS), Madrid, Spain

CIBER Enfermedades Respiratorias (CIBERES), Madrid, Spain

Medicine Department, Universidad de Alcalá, Madrid, Spain
Pedro-Tudela A:: Respiratory Department, Hospital Dr. Peset, Valencia, Spain
Pérez-Ductor C:: Emergency Department, Hospital Dr. Peset, Valencia, Spain
Fernández-Capitán C:: Department of Internal Medicine, Hospital Universitario La Paz, Madrid, Spain
Falgá C:: Department of Internal Medicine, Hospital de Mataró, Barcelona, Spain
Skride A:: Department of Cardiology, Ospedale Pauls Stradins Clinical University Hospital, Riga Stradinš University, Riga, Latvia
Siniscalchi C:: Department of Angiology, Azienda Ospedaliera Universitaria, Parma, Italy
Weinberg I:: Department of Cardiology, Massachusetts General Hospital, Boston, MA, USA
Monreal M:: CIBER Enfermedades Respiratorias (CIBERES), Madrid, Spain

Chair for the Study of Thromboembolic Disease, Faculty of Health Sciences, UCAM - Universidad Católica San Antonio de Murcia, Spain