Thromb Haemost 2008; 99(03): 546-551
DOI: 10.1160/TH07-10-0611
Blood Coagulation, Fibrinolysis and Cellular Haemostasis
Schattauer GmbH

Clinical presentation and time-course of postoperative venous thromboembolism: Results from the RIETE Registry

Juan Ignacio Arcelus
1   Departamento de Cirugía de la Universidad de Granada y Hospital Virgen de las Nieves, Granada, Spain
,
Manuel Monreal
2   Servicio de Medicina Interna, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
,
Joseph A. Caprini
3   Department of Surgery, Evanston Northwestern Healthcare, Evanston, Illinois, USA
,
Javier Gutiérrez Guisado
4   Servicio de Medicina Interna, Hospital Asepeyo Coslada, Madrid, Spain
,
Mª José Soto
5   Servicio de Medicina Interna, Hospital Universitario Puerta del Mar, Cádiz, Spain
,
Manuel Jesús Núñez
6   Servicio de Medicina Interna, Hospital Comarcal de Salnés, Pontevedra, Spain
,
Juan Carlos Alvárez
7   Servicio de Medicina Interna, Hospital Virgen de Macarena, Sevilla, Spain
,
the RIETE investigators › Institutsangaben
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Publikationsverlauf

Received: 15. Oktober 2007

Accepted after major revision: 16. Februar 2007

Publikationsdatum:
07. Dezember 2017 (online)

Summary

There is little literature about the clinical presentation and timecourse of postoperative venous thromboembolism (VTE) in different surgical procedures. RIETE is an ongoing, prospective registry of consecutive patients with objectively confirmed, symptomatic acuteVTE.In this analysis,we analysed the baseline characteristics, thromboprophylaxis and therapeutic patterns, timecourse, and three-month outcome of all patients with postoperative VTE. As of January 2006, there were 1,602 patients with postoperativeVTE in RIETE: 393 (25%) after major orthopaedic surgery (145 elective hip arthroplasty, 126 knee arthroplasty, 122 hip fracture); 207 (13%) after cancer surgery; 1,002 (63%) after other procedures. The percentage of patients presenting with clinically overt pulmonary embolism (PE) (48%, 48%, and 50% respectively), the average time elapsed from surgery toVTE (22 ± 16, 24 ± 16, and 21 ± 15 days, respectively), and the three- month incidence of fatal PE (1.3%, 1.4%, and 0.8%, respectively), fatal bleeding (0.8%, 1.0%, and 0.2%, respectively), or major bleeding (2.3%, 2.9%, and 2.8%, respectively) were similar in the three groups. However, the percentage of patients who had received thromboprophylaxis (96%, 76% and 52%, respectively), the duration of prophylaxis (17 ± 9.6, 13 ± 8.9, and 12 ± 11 days, respectively) and the mean daily doses of low-molecular-weight heparin (4,252 ± 1,016, 3,260 ± 1,141, and 3,769 ± 1,650 IU, respectively), were significantly lower in those undergoing cancer surgery or other procedures. In conclusion, the clinical presentation, time-course, and three-month outcome ofVTE was similar among the different subgroups of patients,but the use of prophylaxis in patients undergoing cancer surgery or other procedures was suboptimal.

Notes

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


 
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