Abstract Number: PB1215
Meeting: ISTH 2021 Congress
Theme: Venous Thromboembolism » VTE Epidemiology
Background: Although mortality rate of venous thromboembolism (VTE) is lower in younger patients, its incidence remains high even with various modifiable risk factors, principally in Brazil, where VTE management data is scarce.
Aims: Evaluate the management of patients with deep venous thromboembolism (DVT) and/or pulmonary embolism (PE) in private hospital in Salvador, participating in the RIETE registry.
Methods: Prospective cohort which evaluated consecutive patients from 5/2018-9/2019 and compared differences between ages, classic inferential descriptive analyzes were used.
Results: Of the 95 patients, 67.4% were women, the mean age 53,3 years (± 19) and 32.8% of women, vs. 9.6% of men were ≤40 years (p=0.01). Among risk factors for VTE, 64.2% were overweight, 31.6% had obesity, 23.2% cancer, 20% history of VTE, 28.1% of women used hormones, 17.9% surgery ≤ 2 months. Thus, only cancer and hormone therapy differed significantly between ages. There were 64.2% PE, 17.9% DVT and 17.9% DVT/PE, with more patients >40 years-old having PE (64.8% vs 62.5%) and more patients ≤40 having combined DVT/PE (20.8% vs 16.9%). Diagnostic tool more utilized was angiotomography, used in 85.3% of patients; 32.6% were admitted to intensive care unit; mean length-of-stay was longer for patients >40 (10.2±14 vs 5.8±3.7 days). The initial choice of anticoagulant was enoxaparin in 88.4%, rivaroxaban 6.3%, warfarin 2.1%, 3.2% others DOACS. There was more indication of anticoagulation after discharge in patients ≤40 (91.7% vs 78.9%); the choice for maintenance was rivaroxaban 37.9%, apixaban 21.1%, 16.8% warfarin, 4.2% edoxaban and 3.2% enoxaparin.
| Risk factors for VTE | Total N (%) |
≤ 40 years N (%) |
> 40 years N (%) |
P value |
|---|---|---|---|---|
| Overweight | 61 (64.7) | 13 (54.2) | 48 (67.6) | 0.23 |
| Obesity | 30 (31.6) | 7 (29.2) | 23 (32.4) | 0.76 |
| Smoking | 7 (7.4) | 1 (4.2) | 6 (8.5) | 0.48 |
| Cancer | 22 (23.2) | 1 (4.2) | 21 (29.6) | 0.01 |
| Immobility > 4 days | 9 (9.5) | 0 (0) | 9 (12.7) | 0.06 |
| History of VTE | 19 (20) | 6 (25) | 13 (18.3) | 0.47 |
| Hormone therapy | 18 (18.9) | 10 (41.7) | 8 (11.3) | 0.001 |
| Surgery, past 2 months | 17 (17.9) | 4 (16.7) | 13 (18.3) | 0.85 |
Risk factors of patients with diagnosis of venous tromboembolism (VTE)
| Anticoagulant | Total N (%) |
≤ 40 years N (%) |
> 40 years N (%) |
P value |
|---|---|---|---|---|
| Indication for maintenance | 78 (82.1) | 22 (91.7) | 56 (78.9) | 0.15 |
| Rivaroxaban | 36 (37.9) | 11 (45.8) | 25 (35.2) | 0.35 |
| Apixaban | 20 (21.1) | 5 (20.8) | 15 (21.1) | 0.97 |
| Edoxaban | 4 (4.2) | 0 (0) | 4 (5.6) | 0.12 |
| Warfarin | 16 (16.8) | 5 (20.8) | 11 (15.5) | 0.54 |
| Enoxaparin | 3 (3.2) | 1 (4.2) | 2 (2.8) | 0.74 |
| Total | 95 (100) | 24 (100) | 71 (100) |
Anticoagulation therapy for maintenance after discharge
Conclusions: This cohort had more women with VTE, particularlly the group of patients ≤40 years-old; high rates of PE and strong risk factors such as cancer, hormone use and obesity. Enoxaparin was still the main choice for initial treatment; younger population had more indication of anticoagulation after discharge and DOACS were more common in the maintenance of the coagulation.
To cite this abstract in AMA style:
Santos de Oliveira Júnior R, Abreu Couto Vieira J, Cavalcanti Rocha AT. Venous Thromboembolism Profile and Management Differences between Ages in a RIETE’s Hospital of Brazil [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 2). https://abstracts.isth.org/abstract/venous-thromboembolism-profile-and-management-differences-between-ages-in-a-rietes-hospital-of-brazil/. Accessed December 6, 2023.« Back to ISTH 2021 Congress
ISTH Congress Abstracts - https://abstracts.isth.org/abstract/venous-thromboembolism-profile-and-management-differences-between-ages-in-a-rietes-hospital-of-brazil/