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    Patient outcomes after deep vein thrombosis and pulmonary embolism: the Worcester Venous Thromboembolism Study

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    Authors
    Spencer, Frederick A.
    Gore, Joel M.
    Lessard, Darleen M.
    Douketis, James D.
    Emery, Cathy
    Goldberg, Robert J.
    UMass Chan Affiliations
    Department of Medicine, Division of Cardiovascular Medicine
    Document Type
    Journal Article
    Publication Date
    2008-02-27
    Keywords
    Aged
    Female
    Humans
    Male
    Middle Aged
    Pulmonary Embolism
    Treatment Outcome
    Venous Thrombosis
    Bioinformatics
    Biostatistics
    Epidemiology
    Health Services Research
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    Link to Full Text
    http://dx.doi.org/10.1001/archinternmed.2007.69
    Abstract
    BACKGROUND: Despite advances in the management of deep vein thrombosis (DVT) and pulmonary embolism (PE), relatively few contemporary data describe and compare outcomes in patients with these common conditions from a more generalizable community-based perspective. The purpose of this study was to measure and compare clinical characteristics and outcomes of patients with validated symptomatic PE and isolated DVT in a New England community. METHODS: The medical records of residents from the Worcester area with International Classification of Diseases, Ninth Revision (ICD-9) codes consistent with possible venous thromboembolism (VTE) during 1999, 2001, and 2003 were independently validated and reviewed by trained abstractors. RESULTS: Patients who presented with PE or isolated DVT experienced similar rates of subsequent PE, overall VTE, and major bleeding during 3-year follow-up (5.9% vs 5.1%, 15.0% vs 17.9%, and 15.6% vs 12.4%, respectively). Mortality was significantly increased at 1-month follow-up in patients who initially presented with PE (13.0% vs 5.4%); this difference persisted at 3 years (35.3% vs 29.6%). Patients whose course was complicated by major bleeding were more likely to experience recurrent VTE or to die at 3 years than those without these complications. CONCLUSIONS: Patients who presented with PE had similar rates of subsequent PE or recurrent VTE compared with patients with isolated DVT. However, rates of recurrent VTE and major bleeding after DVT and PE remain unacceptably high in the community setting. Efforts are needed to identify patients most at risk for VTE-associated complications and to develop better anticoagulation strategies conducive to long-term use in the community setting.
    Source
    Arch Intern Med. 2008 Feb 25;168(4):425-30. Link to article on publisher's site
    DOI
    10.1001/archinternmed.2007.69
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/47199
    PubMed ID
    18299499
    Related Resources
    Link to Article in PubMed
    ae974a485f413a2113503eed53cd6c53
    10.1001/archinternmed.2007.69
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    Population and Quantitative Health Sciences Publications

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