0
Original Research: Pulmonary Vascular Disease |

DVT Management and Outcome Trends, 2001 to 2014

Raquel Morillo, MD; David Jiménez, PhD; Miguel Ángel Aibar, MD; Daniela Mastroiacovo, MD; Philip S. Wells, MD; Ángel Sampériz, PhD; Marta Saraiva de Sousa, MD; Alfonso Muriel, PhD; Roger D. Yusen, MD; Manuel Monreal, PhD
Author and Funding Information

Drs Morillo and Jiménez contributed equally to this manuscript.

FUNDING/SUPPORT: The authors have reported to CHEST that no funding was received for this study.

aRespiratory Department, Ramón y Cajal Hospital and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain

bDepartment of Internal Medicine, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain

cUOSD Angiologia e Diagnostica Vascolare, Ospedale SS, Filippo e Nicola, Avezzano, Italy

dDepartment of Medicine, University of Ottawa, Ottawa Hospital Research Institute, Ontario, Canada

eDepartment of Internal Medicine, Hospital Reina Sofía, Navarra, Spain

fDepartment of Internal Medicine, Centro Hospitalar Gaia/Espinho, Entidade Pública Empresarial, Vila Nova de Gaia, Portugal

gBiostatistics Department, Ramón y Cajal Hospital and IRYCIS, Centro de Investigación Biomédica En Red, Epidemiología y Salud Pública, Madrid, Spain

hDivisions of Pulmonary and Critical Care Medicine and General Medical Sciences, Washington University School of Medicine, St. Louis, Missouri

iDepartment of Internal Medicine, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona; Universidad Católica de Murcia, Murcia, Spain

CORRESPONDENCE TO: David Jiménez, PhD, Respiratory Department and Medicine Department, Ramón y Cajal Hospital, IRYCIS and Alcalá de Henares University, 28034 Madrid, Spain


Copyright 2016, American College of Chest Physicians. All Rights Reserved.


Chest. 2016;150(2):374-383. doi:10.1016/j.chest.2016.03.046
Text Size: A A A
Published online

Background  A comprehensive evaluation of temporal trends in the treatment of patients who have DVT may assist with identification of modifiable factors that contribute to short-term outcomes.

Methods  We assessed temporal trends in length of hospital stay and use of pharmacological and interventional therapies among 26,695 adults with DVT enrolled in the Registro Informatizado de la Enfermedad TromboEmbólica registry between 2001 and 2014. We also examined temporal trends in risk-adjusted rates of all-cause, pulmonary embolism-related, and bleeding-related death to 30 days after diagnosis.

Results  The mean length of hospital stay decreased from 9.0 days in 2001 to 2005 to 7.6 days in 2010 to 2014 (P < .01). For initial DVT treatment, the use of low-molecular-weight heparin decreased from 98% to 90% (P < .01). Direct oral anticoagulants use increased from 0.5% in 2010 to 13.4% in 2014 (P < .001). Risk-adjusted rates of 30-day all-cause mortality decreased from 3.9% in 2001 to 2005 to 2.7% in 2010 to 2014 (adjusted rate ratio per year, 0.84; 95% CI, 0.74-0.96; P < .01). VTE-related mortality showed a nonstatistically significant downward trend (adjusted rate ratio per year, 0.70; 95% CI, 0.44-1.10; P = .13), whereas 30-day bleeding-related mortality significantly decreased from 0.5% in 2001 to 2005 to 0.1% in 2010-2014 (adjusted rate ratio per year, 0.55; 95% CI, 0.40-0.77; P < .01).

Conclusions  This international registry-based temporal analysis identified reductions in length of stay for adults hospitalized for DVT. The study also found a decreasing trend in adjusted rates of all-cause and bleeding-related mortality.

Figures in this Article

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
The Natural Course of Hemodynamically Stable Pulmonary Embolism*: Clinical Outcome and Risk Factors in a Large Prospective Cohort Study
PubMed Articles
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543