Long-Term Survival After Venous Thromboembolism: A Prospective Cohort Study.

Nilius, Henning; Mertins, Tamara; Boss, Robin; Knuchel, Matthias; Blozik, Eva; Kremer Hovinga, Johanna Anna; Eichinger, Sabine; Nagler, Michael (2021). Long-Term Survival After Venous Thromboembolism: A Prospective Cohort Study. Frontiers in cardiovascular medicine, 8(749342), p. 749342. Frontiers 10.3389/fcvm.2021.749342

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Background: Little is known about long-term survival after the initial treatment of venous thromboembolism (VTE). In a prospective cohort study, we aimed to assess the long-term mortality and key predictor variables relating to disease severity, treatment intensity, and comorbidities. Materials and Methods: Between 1988 and 2018, 6,243 consecutive patients with VTE from a University outpatient unit were prospectively included and followed until December 2019; clinical characteristics, measures of disease severity, and treatment details were recorded. Dates of death were retrieved from the Swiss Central Compensation Office. Results: Overall, 254 deaths occurred over an observation period of 57,212 patient-years. Compared to the Swiss population, the standardized mortality ratio was 1.30 (95% CI: 1.14, 1.47; overall mortality rate: 4.44 per 1,000 patient-years). The following predictors were associated with increased mortality: Unprovoked VTE (hazard ratio [HR]: 5.06; 95% CI: 3.29, 7.77), transient triggering risk factors (HR: 3.46; 95% CI: 2.18, 5.48), previous VTE (HR: 2.05; 95% CI: 1.60, 2.62), pulmonary embolism (HR: 1.45, 95% CI: 1.10, 1.89), permanent anticoagulant treatment (HR: 3.14; 95% CI: 2.40, 4.12), prolonged anticoagulant treatment (7-24 months; HR: 1.70; 95% CI: 1.16, 2.48), and cardiovascular comorbidities. Unprovoked VTE, previous VTE, permanent and prolonged anticoagulation remain independent risk factors after adjustment for age, sex, and comorbidities. Conclusion: Survival after VTE was significantly reduced compared to the Swiss general population, especially in patients with more severe disease, cardiovascular comorbidities, and longer anticoagulant treatment.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Haematology and Central Haematological Laboratory
04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Institute of Clinical Chemistry

UniBE Contributor:

Nilius, Henning Jürgen Jean, Knuchel, Matthias Philipp, Kremer Hovinga Strebel, Johanna Anna, Nagler, Michael

Subjects:

600 Technology > 610 Medicine & health

ISSN:

2297-055X

Publisher:

Frontiers

Language:

English

Submitter:

Karin Balmer

Date Deposited:

05 Nov 2021 09:06

Last Modified:

02 Mar 2023 23:35

Publisher DOI:

10.3389/fcvm.2021.749342

PubMed ID:

34660749

Uncontrolled Keywords:

cohort study epidemiology mortality thrombosis venous thrombosis

BORIS DOI:

10.48350/160505

URI:

https://boris.unibe.ch/id/eprint/160505

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