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
AU - Sampériz, Ángel
AU - Saraiva de Sousa, Marta
AU - Muriel, Alfonso
AU - Yusen, Roger D.
AU - Monreal, Manuel
AU - RIETE Investigators
A2 - Decousus, Hervè
A2 - Prandoni, Paolo
A2 - Brenner, Benjamin
A2 - Barba, Raquel
A2 - Di Micco, Pierpaolo
A2 - Bertoletti, Laurent
A2 - Schellong, Sebastian
A2 - Tzoran, Inna
A2 - Reis, Abilio
A2 - Bosevski, Marijan
A2 - Bounameaux, Henri
A2 - Malý, Radovan
A2 - Wells, Philip
A2 - Papadakis, Manolis
A2 - Agudo, P.
A2 - Akasbi, M.
A2 - Alcalde-Manero, M.
A2 - Andújar, V.
A2 - Arcelus, J. I.
A2 - Ballaz, A.
A2 - Barrón, M.
A2 - Casado, I.
A2 - de Miguel, J.
A2 - del Toro, J.
A2 - Falgá, C.
A2 - Fernández-Capitán, C.
A2 - Drucka, E.
A2 - Kigitovica, D.
A2 - Skride, A.
N1 - Funding Information:
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.).
Publisher Copyright:
© 2016 American College of Chest Physicians
PY - 2016/8
Y1 - 2016/8
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
UR - https://www.riete.org/info/centros_participantes/index.php
U2 - 10.1016/j.chest.2016.03.046
DO - 10.1016/j.chest.2016.03.046
M3 - Article
C2 - 27071810
AN - SCOPUS:84981266568
SN - 0012-3692
VL - 150
SP - 374
EP - 383
JO - Chest
JF - Chest
IS - 2
ER -