Effect of the time of diagnosis on outcome in patients with acute venous thromboembolism

Ramón Lecumberri; Silvia Soler; Jorge Del Toro; Raquel Barba; Vladimir Rosa; Maurizio M. Ciammaichella; Manuel Monreal; the RIETE Investigators

doi:10.1160/TH10-07-0480

Thrombosis and Haemostasis, Inhaltsverzeichnis

Thromb Haemost 2011; 105(01): 45-51
DOI: 10.1160/TH10-07-0480

Blood Coagulation, Fibrinolysis and Cellular Haemostasis

Schattauer GmbH

Effect of the time of diagnosis on outcome in patients with acute venous thromboembolism

Findings from the RIETE Registry

Ramón Lecumberri

¹Department of Haematology, Clínica Universitaria de Navarra, Pamplona, Navarra, Spain

,

Silvia Soler

²Department of Internal Medicine, Hospital Sant Jaume d’Olot, Gerona, Spain

,

Jorge Del Toro

³Department of Internal Medicine, Hospital General Universitario Gregorio Marañon, Madrid, Spain

,

Raquel Barba

⁴Department of Internal Medicine, Hospital Infanta Cristina, Madrid, Spain

,

Vladimir Rosa

⁵Department of Internal Medicine, Hospital Universitario Virgen de la Arrixaca, Murcia, Spain

,

Maurizio M. Ciammaichella

⁶Department of Internal Medicine, Ospedale St. John, Rome, Italy

,

Manuel Monreal

¹Department of Haematology, Clínica Universitaria de Navarra, Pamplona, Navarra, Spain

,

the RIETE Investigators

› Institutsangaben

Abstract

Summary

The influence of the day of diagnosis (weekends vs. weekdays) on outcome in patients with acute venous thromboembolism (VTE) has not been thoroughly studied. We used the RIETE database to compare the clinical characteristics, treatment details, and mortality rate at 7 and 30 days, of all patients diagnosed with acute VTE on weekends versus those diagnosed on weekdays. Up to January 2010, 30,394 patients were included in RIETE, of whom 5,479 (18%) were diagnosed on weekends. Most clinical characteristics were similar in both groups, but patients diagnosed on weekends had less often cancer (20% vs. 22%; p=0.004), and presented more likely with pulmonary embolism (PE) than those diagnosed on weekdays (52% vs. 47%; p <0.001). Most patients in both groups received initial therapy with low-molecular-weight heparin (90% and 91%, respectively; p=0.01), then switched to vitamin K antagonists (72% and 71%, respectively; p=0.007). The 7-day mortality rate in patients presenting with PE was 2.75% in those diagnosed on weekends versus 3.00% in those diagnosed on weekdays (p=0.49). At 30 days, the mortality rate was 6.51% versus 6.06%, respectively (p=0.38). In patients presenting with deep vein thrombosis alone, the 7-day mortality rate in those diagnosed on weekends was 1.04% versuss 0.66% in those diagnosed on weekdays (p=0.053). The mortality rate at 30 days was of 3.41% versus 2.88% (p=0.14), respectively. In RIETE, the clinical characteristics, treatment strategies, and 7– and 30-day mortality rates of patients diagnosed on weekends were similar to those in patients diagnosed on weekdays.

Keywords

Deep venous thrombosis - outcome - pulmonary embolism - weekdays - weekends

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Referenzen

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