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Predictors of in-hospital mortality in elderly patients with acute venous thrombo-embolism: the SWIss Venous ThromboEmbolism Registry (SWIVTER)

Spirk, David ; Husmann, Marc ; Hayoz, Daniel ; Baldi, Thomas ; Frauchiger, Beat ; Engelberger, Rolf ; Amann-Vesti, Beatrice ; Baumgartner, Iris ; Kucher, Nils

In: European Heart Journal, 2012, vol. 33, no. 7, p. 921-926

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    Titel
    • Predictors of in-hospital mortality in elderly patients with acute venous thrombo-embolism: the SWIss Venous ThromboEmbolism Registry (SWIVTER)
    Autor
    • Spirk, David. Medical Affairs, Sanofi-Aventis (Suisse) SA, Meyrin, Switzerland
    • Husmann, Marc. Clinic of Angiology, University Hospital Zurich, Zurich, Switzerland
    • Hayoz, Daniel. Department of Internal Medicine, Cantonal Hospital Fribourg, Fribourg, Switzerland
    • Baldi, Thomas. Department of Internal Medicine, University Hospital Basel, Basel, Switzerland
    • Frauchiger, Beat. Department of Internal Medicine, Cantonal Hospital Frauenfeld, Frauenfeld, Switzerland
    • Engelberger, Rolf. Division of Vascular Medicine, Swiss Cardiovascular Center, University Hospital Bern, Bern 3010, Switzerland
    • Amann-Vesti, Beatrice. Clinic of Angiology, University Hospital Zurich, Zurich, Switzerland
    • Baumgartner, Iris. Division of Vascular Medicine, Swiss Cardiovascular Center, University Hospital Bern, Bern 3010, Switzerland
    • Kucher, Nils. Division of Vascular Medicine, Swiss Cardiovascular Center, University Hospital Bern, Bern 3010, Switzerland
    Dokumententyp
    • Postprint
    Sprache
    • Englisch
    Veröffentlicht in
    • European Heart Journal, 2012, vol. 33, no. 7, p. 921-926. Oxford University Press
    Andere elektronische Ausgabe
    OAI-PMH-ID
    • oai:doc.rero.ch:301755
    Summary
    Aims Although acute venous thrombo-embolism (VTE) often afflicts patients with advanced age, the predictors of in-hospital mortality for elderly VTE patients are unknown. Methods and results Among 1247 consecutive patients with acute VTE from the prospective SWIss Venous ThromboEmbolism Registry (SWIVTER), 644 (52%) were elderly (≥65 years of age). In comparison to younger patients, the elderly more often had pulmonary embolism (PE) (60 vs. 42%; P< 0.001), cancer (30 vs. 20%; P< 0.001), chronic lung disease (14 vs. 8%; P= 0.001), and congestive heart failure (12 vs. 2%; P< 0.001). Elderly VTE patients were more often hospitalized (75 vs. 52%; P< 0.001), and there was no difference in the use of thrombolysis, catheter intervention, or surgical embolectomy between the elderly and younger PE patients (5 vs. 6%; P= 0.54), despite a trend towards a higher rate of massive PE in the elderly (8 vs. 4%; P= 0.07). The overall in-hospital mortality rate was 6.6% in the elderly vs. 3.2% in the younger VTE patients (P= 0.033). Cancer was associated with in-hospital death both in the elderly [hazard ratio (HR) 4.91, 95% confidence interval (CI) 2.32-10.38; P< 0.001] and in the younger patients (HR 4.90, 95% CI 1.37-17.59; P= 0.015); massive PE was a predictor of in-hospital death in the elderly only (HR 3.77, 95% CI 1.63-8.74; P= 0.002). Conclusion Elderly patients had more serious VTE than younger patients, and massive PE was particularly life-threatening in the elderly