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Clinical presentation and time-course of postoperative venous thromboembolism: Results from the RIETE Registry

Journal: Thrombosis and Haemostasis
ISSN: 0340-6245
Topic:

From Molecules to Medicine: New Horizons in Vascular Biology and Thrombosis (Part II)

DOI: https://doi.org/10.1160/TH07-10-0611
Issue: 2008: 99/3 (Mar) pp. 457-645
Pages: 546-551

Clinical presentation and time-course of postoperative venous thromboembolism: Results from the RIETE Registry

Juan Ignacio Arcelus 1, Manuel Monreal 2, Joseph A. Caprini 3, Javier Gutiérrez Guisado 4, Mª José Soto 5, Manuel Jesús Núñez 6, Juan Carlos Alvárez 7, and the RIETE investigators
1 Departamento de Cirugía de la Universidad de Granada y Hospital Virgen de las Nieves, Granada, Spain; 2 Servicio de Medicina Interna, Hospital Universitari Germans Trias i Pujol, Badalona, Spain; 3 Department of Surgery, Evanston Northwestern Healthcare, Evanston, Illinois, USA; 4 Servicio de Medicina Interna, Hospital Asepeyo Coslada, Madrid, Spain; 5 Servicio de Medicina Interna, Hospital Universitario Puerta del Mar, Cádiz, Spain; 6 Servicio de Medicina Interna, Hospital Comarcal de Salnés, Pontevedra, Spain; 7 Servicio de Medicina Interna, Hospital Virgen de Macarena, Sevilla, Spain; and the RIETE Investigators*

Keywords

surgery, venous thromboembolism

Summary

There is little literature about the clinical presentation and timecourse of postoperative venous thromboembolism (VTE) in different surgical procedures. RIETE is an ongoing, prospective registry of consecutive patients with objectively confirmed, symptomatic acuteVTE.In this analysis,we analysed the baseline characteristics, thromboprophylaxis and therapeutic patterns, timecourse, and three-month outcome of all patients with postoperative VTE. As of January 2006, there were 1,602 patients with postoperativeVTE in RIETE: 393 (25%) after major orthopaedic surgery (145 elective hip arthroplasty, 126 knee arthroplasty, 122 hip fracture); 207 (13%) after cancer surgery; 1,002 (63%) after other procedures. The percentage of patients presenting with clinically overt pulmonary embolism (PE) (48%, 48%, and 50% respectively), the average time elapsed from surgery toVTE (22 ± 16, 24 ± 16, and 21 ± 15 days, respectively), and the threemonth incidence of fatal PE (1.3%, 1.4%, and 0.8%, respectively), fatal bleeding (0.8%, 1.0%, and 0.2%, respectively), or major bleeding (2.3%, 2.9%, and 2.8%, respectively) were similar in the three groups. However, the percentage of patients who had received thromboprophylaxis (96%, 76% and 52%, respectively), the duration of prophylaxis (17 ± 9.6, 13 ± 8.9, and 12 ± 11 days, respectively) and the mean daily doses of low-molecular-weight heparin (4,252 ± 1,016, 3,260 ± 1,141, and 3,769 ± 1,650 IU, respectively), were significantly lower in those undergoing cancer surgery or other procedures. In conclusion, the clinical presentation, time-course, and three-month outcome ofVTE was similar among the different subgroups of patients,but the use of prophylaxis in patients undergoing cancer surgery or other procedures was suboptimal.

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