Predictive factors for concurrent deep-vein thrombosis and symptomatic venous thromboembolic recurrence in case of superficial venous thrombosis

Jean-Philippe Galanaud; Celine Genty; Marie-Antoinette Sevestre; Dominique Brisot; Michel Lausecker; Jean-Luc Gillet; Carole Rolland; Marc Righini; Georges Leftheriotis; Jean-Luc Bosson; Isabelle Quere; the OPTIMEV SFMV investigators

doi:10.1160/TH10-06-0406

Thrombosis and Haemostasis, Inhaltsverzeichnis

Thromb Haemost 2011; 105(01): 31-39
DOI: 10.1160/TH10-06-0406

Blood Coagulation, Fibrinolysis and Cellular Haemostasis

Schattauer GmbH

Predictive factors for concurrent deep-vein thrombosis and symptomatic venous thromboembolic recurrence in case of superficial venous thrombosis

The OPTIMEV study

Jean-Philippe Galanaud

¹Vascular medicine unit, Department of internal medicine, University Hospital, Montpellier, France

²Research Unit EA2992, Montpellier 1 University, Montpellier, France

,

Celine Genty

³Techniques de l’Ingénierie Médicale et de la Complexité (TIMC), Unité Mixte de Recherche 5525, Centre National de la Recherche Scientifique (CNRS), Université Joseph Fourier, Grenoble, France

⁴Clinical Investigation Center, University Hospital, Grenoble, France

,

Marie-Antoinette Sevestre

³Techniques de l’Ingénierie Médicale et de la Complexité (TIMC), Unité Mixte de Recherche 5525, Centre National de la Recherche Scientifique (CNRS), Université Joseph Fourier, Grenoble, France

⁴Clinical Investigation Center, University Hospital, Grenoble, France

⁵Vascular medicine Unit, Amiens University Hospital, Amiens, France

,

Dominique Brisot

¹Vascular medicine unit, Department of internal medicine, University Hospital, Montpellier, France

⁶Vascular medicine physician, Clapiers, France

,

Michel Lausecker

⁷Vascular medicine physician, Selestat, France

,

Jean-Luc Gillet

⁸Vascular medicine physician, Bourgoin-Jallieu, France

,

Carole Rolland

³Techniques de l’Ingénierie Médicale et de la Complexité (TIMC), Unité Mixte de Recherche 5525, Centre National de la Recherche Scientifique (CNRS), Université Joseph Fourier, Grenoble, France

⁴Clinical Investigation Center, University Hospital, Grenoble, France

,

Marc Righini

⁹Division of Angiology and Haemostasis, Geneva University Hospital, Geneva, Switzerland

,

Georges Leftheriotis

¹⁰Vascular Medicine Unit, University Hospital, Angers, France

,

Jean-Luc Bosson

³Techniques de l’Ingénierie Médicale et de la Complexité (TIMC), Unité Mixte de Recherche 5525, Centre National de la Recherche Scientifique (CNRS), Université Joseph Fourier, Grenoble, France

⁴Clinical Investigation Center, University Hospital, Grenoble, France

,

Isabelle Quere

¹Vascular medicine unit, Department of internal medicine, University Hospital, Montpellier, France

²Research Unit EA2992, Montpellier 1 University, Montpellier, France

,

the OPTIMEV SFMV investigators

› Institutsangaben

Abstract

Summary

Superficial venous thrombosis (SVT) prognosis is debated and its management is highly variable. It was the objective of this study to assess predictive risk factors for concurrent deep-vein thrombosis (DVT) at presentation and for three-month adverse outcome. Using data from the prospective multicentre OPTIMEV study, we analysed SVT predictive factors associated with concurrent DVT and three-month adverse outcome. Out of 788 SVT included, 227 (28.8%) exhibited a concurrent DVT at presentation. Age >75years (odds ratio [OR]=2.9 [1.5–5.9]), active cancer (OR=2.6 [1.3–5.2]), inpatient status (OR=2.3 [1.2–4.4]) and SVT on non-varicose veins (OR=1.8 [1.1–2.7]) were significantly and independently associated with an increased risk of concurrent DVT. 39.4% of SVT on non-varicose veins presented a concurrent DVT. However, varicose vein status did not influence the three-month prognosis as rates of death, symptomatic venous thromboembolic (VTE) recurrence and major bleeding were equivalent in both non-varicose and varicose SVTs (1.4% vs. 1.1%; 3.4% vs. 2.8%; 0.7% vs. 0.3%). Only male gender (OR=3.5 [1.1–11.3]) and inpatient status (OR=4.5 [1.3–15.3]) were independent predictive factors for symptomatic VTE recurrence but the number of events was low (n=15, 3.0%). Three-month numbers of deaths (n=6, 1.2%) and of major bleedings (n=2, 0.4%) were even lower, precluding any relevant interpretation. In conclusion, SVT on non-varicose veins and some classical risk factors for DVT were predictive factors for concurrent DVT at presentation. As SVT remains mostly a clinical diagnosis, these data may help selecting patients deserving an ultrasound examination or needing anticoagulation while waiting for diagnostic tests. Larger studies are needed to evaluate predictive factors for adverse outcome.

Keywords

Superficial vein thrombosis - thrombophlebitis - deep-vein thrombosis - pulmonary embolism - varicose veins

Volltext

Referenzen

References
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