Cargando…

The Cumulative Incidence and Risk Factors of Recurrent Venous Thromboembolism in the Elderly

BACKGROUND: Incidence and outcomes of recurrent venous thromboembolism (VTE) in the elderly are still not fully elucidated. The purpose of this study was to determine the incidence and identify the risk factors of VTE recurrence in this population. METHODS: A prospective cohort study of a one-year f...

Descripción completa

Detalles Bibliográficos
Autor principal: Aleidan, Fahad A S
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7585262/
https://www.ncbi.nlm.nih.gov/pubmed/33116554
http://dx.doi.org/10.2147/VHRM.S264814
_version_ 1783599751458979840
author Aleidan, Fahad A S
author_facet Aleidan, Fahad A S
author_sort Aleidan, Fahad A S
collection PubMed
description BACKGROUND: Incidence and outcomes of recurrent venous thromboembolism (VTE) in the elderly are still not fully elucidated. The purpose of this study was to determine the incidence and identify the risk factors of VTE recurrence in this population. METHODS: A prospective cohort study of a one-year follow-up of 277 patients aged ≥65 years with primary VTE was performed at King Abdulaziz Medical City, a tertiary care teaching hospital in Riyadh, Saudi Arabia. Demographic data, risk factors, and the consequences of VTE (recurrence, bleeding, and mortality) were recorded. RESULTS: Of the 277 VTE patients, 39 (14%) were diagnosed with recurrent VTE over a median follow-up period of 12 months. The cumulative incidence of recurrent VTE was 12.75 per hundred patient-year (95% CI, 8.24–17.36). In multivariate Cox regression, malignancy (hazard ratio [HR], 2.87, 95% CI, 1.32–6.24, p=0.008) and surgery (HR 2.78, 95% CI, 1.36–5.67, p=0.005) were identified as independent risk factors for recurrent VTE. Metformin had a significant independent protection effect (HR, 0.16, 95% CI, 0.08–0.33, p<0.001). During follow-up, two patients in the recurrent VTE group and five patients in the group with no recurrent VTE, all of whom were minor bleeding cases, reported no major bleeding. Seven (18%) patients in the recurrent VTE group and nine (4%) patients in the group with no recurrent VTE died (p<0.001). CONCLUSION: The findings of this study show that elderly patients with initial VTE have a recurrent rate (14%), with a cumulative incidence rate of 12.75 per hundred patient-year. Malignancy and surgery were the most important clinical risk factors to impact significantly the development of recurrent VTE in our elderly population. Metformin may have a protective effect against recurrent VTE in the elderly population, and a larger study is needed to validate our findings.
format Online
Article
Text
id pubmed-7585262
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher Dove
record_format MEDLINE/PubMed
spelling pubmed-75852622020-10-27 The Cumulative Incidence and Risk Factors of Recurrent Venous Thromboembolism in the Elderly Aleidan, Fahad A S Vasc Health Risk Manag Original Research BACKGROUND: Incidence and outcomes of recurrent venous thromboembolism (VTE) in the elderly are still not fully elucidated. The purpose of this study was to determine the incidence and identify the risk factors of VTE recurrence in this population. METHODS: A prospective cohort study of a one-year follow-up of 277 patients aged ≥65 years with primary VTE was performed at King Abdulaziz Medical City, a tertiary care teaching hospital in Riyadh, Saudi Arabia. Demographic data, risk factors, and the consequences of VTE (recurrence, bleeding, and mortality) were recorded. RESULTS: Of the 277 VTE patients, 39 (14%) were diagnosed with recurrent VTE over a median follow-up period of 12 months. The cumulative incidence of recurrent VTE was 12.75 per hundred patient-year (95% CI, 8.24–17.36). In multivariate Cox regression, malignancy (hazard ratio [HR], 2.87, 95% CI, 1.32–6.24, p=0.008) and surgery (HR 2.78, 95% CI, 1.36–5.67, p=0.005) were identified as independent risk factors for recurrent VTE. Metformin had a significant independent protection effect (HR, 0.16, 95% CI, 0.08–0.33, p<0.001). During follow-up, two patients in the recurrent VTE group and five patients in the group with no recurrent VTE, all of whom were minor bleeding cases, reported no major bleeding. Seven (18%) patients in the recurrent VTE group and nine (4%) patients in the group with no recurrent VTE died (p<0.001). CONCLUSION: The findings of this study show that elderly patients with initial VTE have a recurrent rate (14%), with a cumulative incidence rate of 12.75 per hundred patient-year. Malignancy and surgery were the most important clinical risk factors to impact significantly the development of recurrent VTE in our elderly population. Metformin may have a protective effect against recurrent VTE in the elderly population, and a larger study is needed to validate our findings. Dove 2020-10-19 /pmc/articles/PMC7585262/ /pubmed/33116554 http://dx.doi.org/10.2147/VHRM.S264814 Text en © 2020 Aleidan. http://creativecommons.org/licenses/by-nc/3.0/ This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).
spellingShingle Original Research
Aleidan, Fahad A S
The Cumulative Incidence and Risk Factors of Recurrent Venous Thromboembolism in the Elderly
title The Cumulative Incidence and Risk Factors of Recurrent Venous Thromboembolism in the Elderly
title_full The Cumulative Incidence and Risk Factors of Recurrent Venous Thromboembolism in the Elderly
title_fullStr The Cumulative Incidence and Risk Factors of Recurrent Venous Thromboembolism in the Elderly
title_full_unstemmed The Cumulative Incidence and Risk Factors of Recurrent Venous Thromboembolism in the Elderly
title_short The Cumulative Incidence and Risk Factors of Recurrent Venous Thromboembolism in the Elderly
title_sort cumulative incidence and risk factors of recurrent venous thromboembolism in the elderly
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7585262/
https://www.ncbi.nlm.nih.gov/pubmed/33116554
http://dx.doi.org/10.2147/VHRM.S264814
work_keys_str_mv AT aleidanfahadas thecumulativeincidenceandriskfactorsofrecurrentvenousthromboembolismintheelderly
AT aleidanfahadas cumulativeincidenceandriskfactorsofrecurrentvenousthromboembolismintheelderly