Please use this identifier to cite or link to this item:
http://hdl.handle.net/20.500.12188/29297
DC Field | Value | Language |
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dc.contributor.author | Moustafa, Farès | en_US |
dc.contributor.author | Stehouwer, Alexander | en_US |
dc.contributor.author | Kamphuisen, Pieter | en_US |
dc.contributor.author | Sahuquillo, Joan Carles | en_US |
dc.contributor.author | Sampériz, Ángel | en_US |
dc.contributor.author | Alfonso, María | en_US |
dc.contributor.author | Pace, Federica | en_US |
dc.contributor.author | Suriñach, José María | en_US |
dc.contributor.author | Blanco-Molina, Ángeles | en_US |
dc.contributor.author | Mismetti, Patrick | en_US |
dc.contributor.author | Monreal, Manuel | en_US |
dc.contributor.author | RIETE Investigators | en_US |
dc.contributor.author | Bosevski, Marijan | en_US |
dc.contributor.author | Zdraveska, Marija | en_US |
dc.contributor.author | Krstevski, Gregor | en_US |
dc.date.accessioned | 2024-02-13T12:17:03Z | - |
dc.date.available | 2024-02-13T12:17:03Z | - |
dc.date.issued | 2018-11 | - |
dc.identifier.uri | http://hdl.handle.net/20.500.12188/29297 | - |
dc.description.abstract | Background: The optimal management of major bleeding in patients receiving vitamin K antagonists (VKA) for venous thromboembolism (VTE) is unclear. Methods: We used the RIETE (Registro Informatizado Enfermedad TromboEmbólica) registry to assess the management and 30-day outcomes after major bleeding in patients receiving VKA for VTE. Results: From January 2013 to December 2017, 267 of 18,416 patients (1.4%) receiving long-term VKA for VTE had a major bleeding (in the gastrointestinal tract 78, intracranial 72, hematoma 50, genitourinary 20, other 47). Overall, 151 patients (57%) received blood transfusion; 110 (41%) vitamin K; 37 (14%) fresh frozen plasma; 29 (11%) pro-haemostatic agents and 20 (7.5%) a vena cava filter. During the first 30 days, 59 patients (22%) died (41 died of bleeding) and 13 (4.9%) had a thrombosis. On multivariable analysis, patients with intracranial bleeding (hazard ratio [HR]: 4.58; 95%CI: 2.40-8.72) and those with renal insufficiency at baseline (HR: 2.73; 95%CI: 1.45-5.15) had an increased mortality risk, whereas those receiving vitamin K had a lower risk (HR: 0.47; 0.24-0.92). On the other hand, patients receiving fresh frozen plasma were at increased risk for thrombotic events (HR: 4.22; 95%CI: 1.25-14.3). Conclusions: Major bleeding in VTE patients receiving VKA carries a high mortality rate. Intracranial bleeding and renal insufficiency increased the risk. Fresh frozen plasma seems to increase this risk for recurrent VTE.Background: The optimal management of major bleeding in patients receiving vitamin K antagonists (VKA) for venous thromboembolism (VTE) is unclear. Methods: We used the RIETE (Registro Informatizado Enfermedad TromboEmbólica) registry to assess the management and 30-day outcomes after major bleeding in patients receiving VKA for VTE. Results: From January 2013 to December 2017, 267 of 18,416 patients (1.4%) receiving long-term VKA for VTE had a major bleeding (in the gastrointestinal tract 78, intracranial 72, hematoma 50, genitourinary 20, other 47). Overall, 151 patients (57%) received blood transfusion; 110 (41%) vitamin K; 37 (14%) fresh frozen plasma; 29 (11%) pro-haemostatic agents and 20 (7.5%) a vena cava filter. During the first 30 days, 59 patients (22%) died (41 died of bleeding) and 13 (4.9%) had a thrombosis. On multivariable analysis, patients with intracranial bleeding (hazard ratio [HR]: 4.58; 95%CI: 2.40-8.72) and those with renal insufficiency at baseline (HR: 2.73; 95%CI: 1.45-5.15) had an increased mortality risk, whereas those receiving vitamin K had a lower risk (HR: 0.47; 0.24-0.92). On the other hand, patients receiving fresh frozen plasma were at increased risk for thrombotic events (HR: 4.22; 95%CI: 1.25-14.3). Conclusions: Major bleeding in VTE patients receiving VKA carries a high mortality rate. Intracranial bleeding and renal insufficiency increased the risk. Fresh frozen plasma seems to increase this risk for recurrent VTE. | en_US |
dc.language.iso | en | en_US |
dc.publisher | Elsevier BV | en_US |
dc.relation.ispartof | Thrombosis Research | en_US |
dc.title | Management and outcome of major bleeding in patients receiving vitamin K antagonists for venous thromboembolism | en_US |
dc.type | Article | en_US |
dc.identifier.doi | 10.1016/j.thromres.2018.09.049 | - |
dc.identifier.url | https://api.elsevier.com/content/article/PII:S0049384818305334?httpAccept=text/xml | - |
dc.identifier.url | https://api.elsevier.com/content/article/PII:S0049384818305334?httpAccept=text/plain | - |
dc.identifier.volume | 171 | - |
dc.identifier.fpage | 74 | - |
dc.identifier.lpage | 80 | - |
item.grantfulltext | open | - |
item.fulltext | With Fulltext | - |
crisitem.author.dept | Faculty of Medicine | - |
crisitem.author.dept | Faculty of Medicine | - |
crisitem.author.dept | Faculty of Medicine | - |
Appears in Collections: | Faculty of Medicine: Journal Articles |
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2018, moustafa, management of bleeding.pdf | 837.19 kB | Adobe PDF | View/Open |
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