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January 1, 2008Thrombosis and Haemostasis

Clinical outcome of patients with major bleeding after venous thromboembolism

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Key result

In patients with VTE and major bleeding, insertion of a vena cava filter was independently associated with a lower incidence of fatal bleeding (OR 0.10; 95% CI 0.01-0.79) and all-cause mortality.

Why the study?

What are the clinical outcomes and mortality rates in patients with VTE who develop major bleeding during the first three months of anticoagulant therapy?

Population

407 patients with symptomatic, objectively confirmed, acute venous thromboembolism who had major bleeding…

Design

Cohort

Follow-up

30 days after bleeding

Authors

JNJosé Antonio NietoUniversidad Nacional de Educación a DistanciaTCTimoteo CámaraHospital Virgen de la LuzEGElena González-HiguerasHospital Virgen de la Luz

Discussion

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Member takes

Overview

May support filter evaluation in VTE with major bleeding; leaves open causal confirmation in randomized trials.

Study Design

Type

Cohort (n=407)

Structured PICO

What are the clinical outcomes and mortality rates in patients with VTE who develop major bleeding during the first three months of anticoagulant therapy?

P
Population
407 patients with acute venous thromboembolism who developed major bleeding during the first three months of anticoagulant therapy, followed for 30 days after the bleeding episode.
E
Exposure
Management of major bleeding (anticoagulant therapy discontinued in 69%, not modified in 18%, vena cava filter inserted in 9.1%)
O
Outcome
All-cause mortality, fatal bleeding, recurrent VTE, and re-bleeding within 30 days after the bleeding episodehard clinical

Main Result

Odds Ratio: 0.1 (95% CI 0.01–0.79)

Major bleeding during the first three months of VTE treatment is associated with an exceptionally high 30-day mortality of 33%, though vena cava filter insertion was associated with reduced mortality.

Cite This Study

Nieto et al. (2008) conducted a cohort in Venous thromboembolism with major bleeding (n=407). Insertion of a vena cava filter vs. No vena cava filter was evaluated on Fatal bleeding (OR 0.10, 95% CI 0.01-0.79). In patients with VTE and major bleeding, insertion of a vena cava filter was independently associated with a lower incidence of fatal bleeding (OR 0.10; 95% CI 0.01-0.79) and all-cause mortality.

synapsesocial.com/papers/6a86ff3fa810ea404bcf9ca1https://doi.org/10.1160/th08-06-0390
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Management of Patients with Acute Venous Thromboembolism: Findings from the RIETE Registry2003 · 63 citations
  2. 2Dynamics of case-fatalilty rates of recurrent thromboembolism and major bleeding in patients treated for venous thromboembolism2013 · 129 citations
  3. 3Predictive variables for major bleeding events in patients presenting with documented acute venous thromboembolism. Findings from the RIETE Registry2008 · 518 citations
  4. 4Systematic Review: Case-Fatality Rates of Recurrent Venous Thromboembolism and Major Bleeding Events Among Patients Treated for Venous Thromboembolism2010 · 471 citations
  5. 5Predicting recurrences or major bleeding in cancer patients with venous thromboembolism2008 · 171 citations