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Mortality rates and risk factors for asymptomatic deep vein thrombosis in medical patients

Vaitkus, P. T.; Leizorovicz, A.; Cohen, A. T.; Turpie, A. G. G.; Olsson, Carl-Gustav LU ; Goldhaber, S. Z. and G, Prevent Thromboprophylaxis Study (2005) In Thrombosis and Haemostasis 93(1). p.76-79
Abstract
The clinical importance of asymptomatic proximal and distal deep vein thrombosis (DVT) remains uncertain and controversial. The aim of this retrospective, post-hoc analysis was to examine mortality and risk factors for development of proximal DVT in hospitalized patients with acute medical illness who were recruited into a randomized, prospective clinical trial of thromboprophylaxis with dalteparin (PREVENT). We analyzed 1738 patients who had not sustained a symptomatic venous thromboembolic event by Day 21 and who had a complete compression ultrasound of the proximal and distal leg veins on Day 21. We examined the 90-day mortality rates in patients with asymptomatic proximal DVT (Group 1, N = 80), asymptomatic distal DVT (Group 11, N =... (More)
The clinical importance of asymptomatic proximal and distal deep vein thrombosis (DVT) remains uncertain and controversial. The aim of this retrospective, post-hoc analysis was to examine mortality and risk factors for development of proximal DVT in hospitalized patients with acute medical illness who were recruited into a randomized, prospective clinical trial of thromboprophylaxis with dalteparin (PREVENT). We analyzed 1738 patients who had not sustained a symptomatic venous thromboembolic event by Day 21 and who had a complete compression ultrasound of the proximal and distal leg veins on Day 21. We examined the 90-day mortality rates in patients with asymptomatic proximal DVT (Group 1, N = 80), asymptomatic distal DVT (Group 11, N = 118) or no DVT (Group 111, N = 1540). The 90-day mortality rates were 13.75%, 3.39%, and 1.92% for Groups I-III, respectively. The difference in mortality between Group I and Group III was significant (hazard ratio 7.63,95% Cl = 3.8-15.3;p < 0.0001), whereas the difference between Groups 11 and III did not reach significance (hazard ratio 1.36,95% Cl = 0.41-4.45). The association of asymptomatic proximal DVT with increased mortality remained highly significant after adjusting for differences in baseline demographics and clinical variables. Risk factors significantly associated with the development of proximal DVT included advanced age (p = 0.0005), prior DVT (p = 0.001), and varicose veins (p = 0.04). In conclusion, the high mortality rate in patients with asymptomatic proximal DVT underscores its clinical relevance and supports targeting of asymptomatic proximal DVT as an appropriate endpoint in clinical trials of thromboprophylaxis. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
PULMONARY-EMBOLISM, CLINICAL-TRIAL, VENOUS THROMBOEMBOLISM, venous embolism, deep vein thrombosis, proximal, prevention, DIAGNOSIS, DALTEPARIN
in
Thrombosis and Haemostasis
volume
93
issue
1
pages
76 - 79
publisher
F K Schattauer Verlag Gmbh
external identifiers
  • wos:000226522600013
  • scopus:12344286240
ISSN
0340-6245
DOI
10.1160/th04-05-0323
language
English
LU publication?
yes
id
c4b67974-9ce0-4844-94bb-845a3b63e29e (old id 1418081)
date added to LUP
2009-06-16 16:51:21
date last changed
2017-10-22 04:41:26
@article{c4b67974-9ce0-4844-94bb-845a3b63e29e,
  abstract     = {The clinical importance of asymptomatic proximal and distal deep vein thrombosis (DVT) remains uncertain and controversial. The aim of this retrospective, post-hoc analysis was to examine mortality and risk factors for development of proximal DVT in hospitalized patients with acute medical illness who were recruited into a randomized, prospective clinical trial of thromboprophylaxis with dalteparin (PREVENT). We analyzed 1738 patients who had not sustained a symptomatic venous thromboembolic event by Day 21 and who had a complete compression ultrasound of the proximal and distal leg veins on Day 21. We examined the 90-day mortality rates in patients with asymptomatic proximal DVT (Group 1, N = 80), asymptomatic distal DVT (Group 11, N = 118) or no DVT (Group 111, N = 1540). The 90-day mortality rates were 13.75%, 3.39%, and 1.92% for Groups I-III, respectively. The difference in mortality between Group I and Group III was significant (hazard ratio 7.63,95% Cl = 3.8-15.3;p &lt; 0.0001), whereas the difference between Groups 11 and III did not reach significance (hazard ratio 1.36,95% Cl = 0.41-4.45). The association of asymptomatic proximal DVT with increased mortality remained highly significant after adjusting for differences in baseline demographics and clinical variables. Risk factors significantly associated with the development of proximal DVT included advanced age (p = 0.0005), prior DVT (p = 0.001), and varicose veins (p = 0.04). In conclusion, the high mortality rate in patients with asymptomatic proximal DVT underscores its clinical relevance and supports targeting of asymptomatic proximal DVT as an appropriate endpoint in clinical trials of thromboprophylaxis.},
  author       = {Vaitkus, P. T. and Leizorovicz, A. and Cohen, A. T. and Turpie, A. G. G. and Olsson, Carl-Gustav and Goldhaber, S. Z. and G, Prevent Thromboprophylaxis Study},
  issn         = {0340-6245},
  keyword      = {PULMONARY-EMBOLISM,CLINICAL-TRIAL,VENOUS THROMBOEMBOLISM,venous embolism,deep vein thrombosis,proximal,prevention,DIAGNOSIS,DALTEPARIN},
  language     = {eng},
  number       = {1},
  pages        = {76--79},
  publisher    = {F K Schattauer Verlag Gmbh},
  series       = {Thrombosis and Haemostasis},
  title        = {Mortality rates and risk factors for asymptomatic deep vein thrombosis in medical patients},
  url          = {http://dx.doi.org/10.1160/th04-05-0323},
  volume       = {93},
  year         = {2005},
}