Thromb Haemost 2010; 104(04): 734-740
DOI: 10.1160/TH10-03-0169
Blood Coagulation, Fibrinolysis and Cellular Haemostasis
Schattauer GmbH

Incidence and predictors of venous thromboembolism in post-acute care patients

A prospective cohort study
Gianluigi Scannapieco
1   Internal Medicine, Cà Foncello Hospital, Treviso, Italy
,
Walter Ageno
2   Department of Clinical Medicine, Insubria University, Varese, Italy
,
Andrea Airoldi
3   Internal Medicine, Maggiore Hospital, Novara, Italy
,
Erminio Bonizzoni
4   Institute of Medical Statistics and Biometry, University of Milan, Milan, Italy
,
Mauro Campanini
3   Internal Medicine, Maggiore Hospital, Novara, Italy
,
Gualberto Gussoni
5   FADOI Foundation Research Centre, Milan, Italy
,
Mauro Silingardi
6   Internal Medicine I, Arcispedale S. Maria Nuova, Reggio Emilia, Italy
,
Antonella Valerio
5   FADOI Foundation Research Centre, Milan, Italy
,
Chiara Zilli
1   Internal Medicine, Cà Foncello Hospital, Treviso, Italy
,
Ido Iori
6   Internal Medicine I, Arcispedale S. Maria Nuova, Reggio Emilia, Italy
,
for the TERSICORE Study Group› Author Affiliations

Financial support:The study was partially supported by an unrestricted grant from AstraZeneca Italy, without involvement in study design, management, analysis and reporting.
Further Information

Publication History

Received: 10 March 2010

Accepted after major revision: 23 April 2010

Publication Date:
24 November 2017 (online)

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Summary

Few studies have addressed the topic of venous thromboembolism (VTE) in patients hospitalised in rehabilitation facilities. This patient population is rapidly growing, and data aimed to better define VTE risk in this setting are needed. Primary aim of this prospective observational study was to evaluate the frequency of symptomatic, objectively confirmed VTE in a cohort of unselected consecutive patients admitted to rehabilitation facilities, after medical diseases or surgery. Further objectives were to assess overall mortality, to identify risk factors for VTE and mortality, and to assess the attitude of physicians towards thromboprophylaxis. A total of 3,039 patients were included in the study, and the median duration of hospitalisation was 26 days. Seventy-two patients (2.4%) had symptomatic VTE. The median time to VTE from admission to the long-term care unit was 13 days. According to multivariable analysis, previous VTE (hazard ratio 5.67, 95% confidence interval 3.30–9.77) and cancer (hazard ratio 2.26, 95% confidence interval 1.36–3.75) were significantly associated to the occurrence of VTE. Overall in-hospital mortality was 15.1%. Age over 75 years, male gender, disability, cancer, and the absence of thromboprophylaxis were significantly associated to an increased risk of death (multivariable analysis). In-hospital antithrombotic prophylaxis was administered to 75.1% of patients, and low-molecular-weight heparin was the most widely used agent. According to our study, patients admitted to rehabilitation facilities remain at substantially increased risk for VTE. Because this applies to the majority of these patients, there is a great need for clinical trials assessing optimal prophylactic strategies.

* A list of the participants in the TERSICORE Study Group is given at the end of the article.