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

Journal: Thrombosis and Haemostasis
ISSN: 0340-6245
DOI: https://doi.org/10.1160/TH10-07-0480
Issue: 2011: 105/1 (Jan) pp. 1–205
Pages: 45-51

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

Findings from the RIETE Registry

R. Lecumberri (1), S. Soler (2), J. Del Toro (3), R. Barba (4), V. Rosa (5), M. M. Ciammaichella (6), M. Monreal (7), the RIETE Investigators

(1) Department of Haematology, Clínica Universitaria de Navarra, Pamplona, Navarra, Spain; (2) Department of Internal Medicine, Hospital Sant Jaume d’Olot, Gerona, Spain; (3) Department of Internal Medicine, Hospital General Universitario Gregorio Marañon, Madrid, Spain; (4) Department of Internal Medicine, Hospital Infanta Cristina, Madrid, Spain; (5) Department of Internal Medicine, Hospital Universitario Virgen de la Arrixaca, Murcia, Spain; (6) Department of Internal Medicine, Ospedale St. John, Rome, Italy; (7) Department of Internal Medicine, Hospital Universitario Germans Trials i Pujol, Badalona, Barcelona, Spain

Keywords

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

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.

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