Thromb Haemost 2009; 101(06): 1112-1118
DOI: 10.1160/TH08-12-0827
Blood Coagulation, Fibrinolysis and Cellular Haemostasis
Schattauer GmbH

Venous thromboembolism in nonagenarians

Findings from the RIETE Registry
Beatriz Vasco
1   Servicio de Hematología, Hospital Virxe da Xunqueira, Coruña, Spain
,
Joan Carles Villalba
2   Unidad de Cuidados Intensivos, Hospital Universitari Germans Trias i Pujol, Badalona, Facultat de Medicina, Universitat Autónoma de Barcelona, Spain
,
Luciano Lopez-Jimenez
3   Servicio de Medicina Interna, Hospital Universitario Reina Sofía, Córdoba, Spain
,
Conxita Falga
4   Servicio de Medicina Interna, Consorci Sanitari del Maresme, Mataró, Spain
,
Julio Montes
5   Servicio de Medicina Interna, Hospital de Meixoeiro, Vigo, Spain
,
Javier Trujillo-Santos
6   Servicio de Medicina Interna, Hospital Universitario Santa María de Rosell, Cartagena, Murcia, Spain
,
Manuel Monreal
7   Servicio de Medicina Interna, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
,
for the RIETE Investigators › Institutsangaben
Weitere Informationen

Publikationsverlauf

Received: 18. Dezember 2008

Accepted after minor revision: 12. Februar 2009

Publikationsdatum:
24. November 2017 (online)

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Summary

The balance between the efficacy and safety of anticoagulant therapy in patients aged ≥90 years with venous thromboembolism (VTE) is uncertain. RIETE is an ongoing, prospective registry of consecutive patients with acute, objectively confirmed, symptomatic VTE. We evaluated the efficacy and safety of anticoagulant therapy during the first three months in all patients aged ≥90 years. In addition, we tried to identify those at a higher risk for VTE. Of 21,873 patients enrolled from March 2001 to February 2008, 610 (2.8%) were aged ≥90 years. Of these, 307 (50%) presented with pulmonary embolism (PE), 240 (39%) had immobility ≥4 days, and 271 (44%) had abnormal creatinine levels. During the first three months of therapy, 140 patients aged ≥90 years (23%) died. Of these, 45 (32%) died of PE (34 of the initial episode, 11 of recurrent PE), 18 (13%) had fatal bleeding. Recent im-mobility ≥4 days was the most common risk factor for VTE (240 of 610 patients, 39%), but only 54 of them (22%) had received thromboprophylaxis. The most frequent causes for immobility were senile dementia, acute infection, trauma or decompen-sated heart failure. The duration of immobility was <4 weeks in 126 patients (52%), and most of them were bedridden at home. In conclusion, one in every four VTE patients aged ≥90 years died during the first three months of therapy. Of these, one in every three died of PE, one in every eight had fatal bleeding. Identifying at-risk patients may help to prevent some of these deaths.

* A full list of RIETE investigators is given in the Appendix.