Predictors and Causes of Long-Term Mortality in Elderly Patients with Acute Venous Thromboembolism: A Prospective Cohort Study.

Détails

ID Serval
serval:BIB_AC776BDD93F1
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Predictors and Causes of Long-Term Mortality in Elderly Patients with Acute Venous Thromboembolism: A Prospective Cohort Study.
Périodique
The American journal of medicine
Auteur(s)
Faller N., Limacher A., Méan M., Righini M., Aschwanden M., Beer J.H., Frauchiger B., Osterwalder J., Kucher N., Lämmle B., Cornuz J., Angelillo-Scherrer A., Matter C.M., Husmann M., Banyai M., Staub D., Mazzolai L., Hugli O., Rodondi N., Aujesky D.
ISSN
1555-7162 (Electronic)
ISSN-L
0002-9343
Statut éditorial
Publié
Date de publication
02/2017
Peer-reviewed
Oui
Volume
130
Numéro
2
Pages
198-206
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: ppublish
Résumé
Long-term predictors and causes of death are understudied in elderly patients with acute venous thromboembolism.
We prospectively followed up 991 patients aged ≥65 years with acute venous thromboembolism in a multicenter Swiss cohort study. The primary outcome was overall mortality. We explored the association between patient baseline characteristics and mortality, adjusting for other baseline variables and periods of anticoagulation as a time-varying covariate. Causes of death over time were adjudicated by a blinded, independent committee.
The median age was 75 years. During a median follow-up period of 30 months, 206 patients (21%) died. Independent predictors of overall mortality were age (hazard ratio [HR], 1.32; 95% confidence interval [CI], 1.05-1.65, per decade), active cancer (HR, 5.80; 95% CI, 4.22-7.97), systolic blood pressure <100 mm Hg (HR, 2.77; 95% CI, 1.56-4.92), diabetes mellitus (HR, 1.50; 95% CI, 1.02-2.22), low physical activity level (HR, 1.92; 95% CI, 1.38-2.66), polypharmacy (HR, 1.41; 95% CI, 1.01-1.96), anemia (HR, 1.48; 95% CI, 1.07-2.05), high-sensitivity C-reactive protein >40 mg/L (HR, 1.88; 95% CI, 1.36-2.60), ultra-sensitive troponin >14 pg/mL (HR, 1.54; 95% CI, 1.06-2.25), and D-dimer >3000 ng/mL (HR, 1.45; 95% CI, 1.04-2.01). Cancer (34%), pulmonary embolism (18%), infection (17%), and bleeding (6%) were the most common causes of death.
Elderly patients with acute venous thromboembolism have a substantial long-term mortality, and several factors, including polypharmacy and a low physical activity level, are associated with long-term mortality. Cancer, pulmonary embolism, infections, and bleeding are the most common causes of death in the elderly with venous thromboembolism.

Mots-clé
Acute Disease, Age Factors, Aged, Aged, 80 and over, Blood Pressure, C-Reactive Protein/analysis, Diabetes Complications/mortality, Exercise, Female, Fibrin Fibrinogen Degradation Products/analysis, Humans, Male, Neoplasms/complications, Polypharmacy, Proportional Hazards Models, Prospective Studies, Risk Factors, Troponin/blood, Venous Thromboembolism/etiology, Venous Thromboembolism/mortality
Pubmed
Création de la notice
25/10/2016 18:03
Dernière modification de la notice
20/08/2019 15:16
Données d'usage