0
Clinical Investigations: PULMONARY EMBOLISM |

Bed Rest or Ambulation in the Initial Treatment of Patients With Acute Deep Vein Thrombosis or Pulmonary Embolism*: Findings From the RIETE Registry

Javier Trujillo-Santos, MD, PhD; Emilio Perea-Milla, MD, PhD; Alberto Jiménez-Puente, MD, PhD; Emilio Sánchez-Cantalejo, MD, PhD; Jorge del Toro, MD; Enric Grau, MD, PhD; Manuel Monreal, MD, PhD; for the RIETE Investigators
Author and Funding Information

Affiliations: *From the Unidades de Medicina Interna (Dr. Trujillo-Santos), de Investigación (Dr. Perea-Milla), and de Evaluación y Control (Dr. Jiménez-Puente), Hospital Costa del Sol, Marbella, Málaga, Spain; Escuela Andaluza de Salud Pública (Dr. Sánchez-Cantalejo), Granada, Spain; Servicio de Medicina Interna (Dr. del Toro), Hospital Gregorio Marañón, Madrid, Spain; Servicio de Hematología (Dr. Grau), Hospital Lluis Alcanyis, Xátiva, Valencia, Spain; and Servicio de Medicina Interna (Dr. Monreal), Hospital Universitari Germans Trias i Pujol, Badalona. Spain.,  A list of RIETE investigators is given in the Appendix.

Correspondence to: Manuel Monreal, MD, PhD, Servicio de Medicina Interna, Hospital Universitari Germans Trias i Pujol, Badalona, Spain; e-mail: mmonreal@ns.hugtip.scs.es



Chest. 2005;127(5):1631-1636. doi:10.1378/chest.127.5.1631
Text Size: A A A
Published online

Background: Traditionally, many patients with acute deep vein thrombosis (DVT) are treated not only by anticoagulation therapy but additionally by strict bed rest, which is aimed at reducing the risk of pulmonary embolism (PE) events. However, this risk has not been subjected to empirical verification.

Patients and methods: The Registro Informatizado de la Enfermedad TromboEmbólica is a Spanish registry of consecutively enrolled patients with objectively confirmed, symptomatic acute DVT or PE. In this analysis, the clinical characteristics, details of anticoagulant therapy, and clinical outcomes of enrolled patients with and without strict bed rest prescribed during the first 15 days were compared. Patients in whom ambulation was not possible were not included in this analysis.

Results: A total of 2,650 patients entered the study (DVT, 2,038 patients; PE, 612 patients). Of these patients, 1,050 DVT patients (52%) and 385 PE patients (63%) were prescribed strict bed rest. New events of symptomatic, objectively confirmed PE developed during the 15-day study period in 11 patients with DVT (0.5%) and 4 patients with PE (0.7%). Five of these 15 patients (33%) died as a result of their PE. Age < 65 years (odds ratio [OR], 3.1; 95% confidence interval [CI], 0.98 to 11) and cancer (OR, 3.0; 95% CI, 0.98 to 9.1) were associated with an increased rate of new PEs. There were not significant differences between bedridden and ambulant patients in terms of new PE events, fatal PE, or bleeding complications.

Conclusions: Our findings confirm those from previous reports suggesting that bed rest has no influence on the risk of developing PE among patients with acute DVT of the lower limbs. In addition, our findings show for the first time the lack of influence of bed rest even in patients presenting with acute submassive PE.


Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Figures

Tables

References

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Find Similar Articles
CHEST Journal Articles
PubMed Articles
Guidelines
Guidelines on use of vena cava filters.
British Committee for Standards in Haematology | 9/25/2009
Guidelines on the use and monitoring of heparin.
British Committee for Standards in Haematology | 9/25/2009
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543