Impact of Thrombus Sidedness on Presentation and Outcomes of Patients with Proximal Lower Extremity Deep Vein Thrombosis

Small studies have suggested differences in demographics and outcomes between left- and right-sided deep vein thrombosis (DVT), and also unilateral versus bilateral DVT. We investigated the clinical presentation and outcomes of patients with DVT based on thrombus sidedness. The authors used the data...

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Autores: Bikdeli, Behnood, Sharif-Kashani, Babak, Bikdeli, Bavand, Valle, Reina, Falga, Conxita, Riera Mestre, Antoni, Mazzolai, Lucia, Verhamme, Peter, Wells, Philip S., Sánchez Muñoz Torrero, Juan Francisco, López Jiménez, Luciano, Monreal, Manuel, RIETE investigadors
Tipo de recurso: artículo
Estado:Versión aceptada para publicación
Fecha de publicación:2018
País:España
Institución:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
Repositorio:Recercat. Dipósit de la Recerca de Catalunya
OAI Identifier:oai:recercat.cat:2445/172460
Acceso en línea:https://hdl.handle.net/2445/172460
Access Level:acceso abierto
Palabra clave:Trombosi
Embòlia pulmonar
Thrombosis
Pulmonary embolism
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spelling Impact of Thrombus Sidedness on Presentation and Outcomes of Patients with Proximal Lower Extremity Deep Vein ThrombosisBikdeli, BehnoodSharif-Kashani, BabakBikdeli, BavandValle, ReinaFalga, ConxitaRiera Mestre, AntoniMazzolai, LuciaVerhamme, PeterWells, Philip S.Sánchez Muñoz Torrero, Juan FranciscoLópez Jiménez, LucianoMonreal, ManuelRIETE investigadorsTrombosiEmbòlia pulmonarThrombosisPulmonary embolismSmall studies have suggested differences in demographics and outcomes between left- and right-sided deep vein thrombosis (DVT), and also unilateral versus bilateral DVT. We investigated the clinical presentation and outcomes of patients with DVT based on thrombus sidedness. The authors used the data from the Registro Informatizado Enfermedad TromboEmbólica (RIETE) database (2001-2016) to identify patients with symptomatic proximal lower-extremity DVT. Main outcomes included cumulative 90-day symptomatic pulmonary embolism (PE) and 1-year mortality. Overall, 30,445 patients were included. The majority of DVTs occurred in the left leg (16,421 left-sided, 12,643 right-sided, and 1,390 bilateral; p < 0.001 for chi-squared test comparing all three groups). Comorbidities were relatively similar in those with left-sided and right-sided DVT. Compared with those with left-sided DVT, patients with right-sided DVT had higher relative frequency of PE (26% versus 23%, p < 0.001) and 1-year mortality (odds ratio [OR]: 1.08; 95% confidence interval [CI]: 1.00-1.18). This difference in mortality did not persist after multivariable adjustment (OR: 1.01; 95% CI: 0.93-1.1). Patients with bilateral DVT had a greater burden of comorbidities such as heart failure, and recent surgery compared with those with unilateral DVT (p < 0.001), and higher relative frequency of PE (48%), and 1-year mortality (24.1%). Worse outcomes in patients with bilateral DVT were attenuated but persisted after multivariable adjustment for demographics and risk factors (OR: 1.64; 95% CI: 1.43-1.87). Patients with bilateral DVT had worse outcomes during and after discontinuation of anticoagulation. There is a left-sided preponderance for proximal lower-extremity DVT. Compared with those with left-sided DVT, patients with right-sided DVT have slightly higher rates of PE. Bilateral DVT is associated with markedly worse short-term and 1-year outcomes.Thieme Medical Publishers2020202020182020info:eu-repo/semantics/articleinfo:eu-repo/semantics/acceptedVersion7 p.application/pdfhttps://hdl.handle.net/2445/172460Articles publicats en revistes (Ciències Clíniques)reponame:Recercat. Dipósit de la Recerca de Catalunyainstname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)InglésVersió postprint del document publicat a: https://doi.org/10.1055/s-0037-1621716Seminars in Thrombosis and Hemostasis, 2018, vol. 44, num. 4, p. 341-347https://doi.org/10.1055/s-0037-1621716(c) Thieme Medical Publishers, 2018info:eu-repo/semantics/openAccessoai:recercat.cat:2445/1724602026-05-29T05:05:01Z
dc.title.none.fl_str_mv Impact of Thrombus Sidedness on Presentation and Outcomes of Patients with Proximal Lower Extremity Deep Vein Thrombosis
title Impact of Thrombus Sidedness on Presentation and Outcomes of Patients with Proximal Lower Extremity Deep Vein Thrombosis
spellingShingle Impact of Thrombus Sidedness on Presentation and Outcomes of Patients with Proximal Lower Extremity Deep Vein Thrombosis
Bikdeli, Behnood
Trombosi
Embòlia pulmonar
Thrombosis
Pulmonary embolism
title_short Impact of Thrombus Sidedness on Presentation and Outcomes of Patients with Proximal Lower Extremity Deep Vein Thrombosis
title_full Impact of Thrombus Sidedness on Presentation and Outcomes of Patients with Proximal Lower Extremity Deep Vein Thrombosis
title_fullStr Impact of Thrombus Sidedness on Presentation and Outcomes of Patients with Proximal Lower Extremity Deep Vein Thrombosis
title_full_unstemmed Impact of Thrombus Sidedness on Presentation and Outcomes of Patients with Proximal Lower Extremity Deep Vein Thrombosis
title_sort Impact of Thrombus Sidedness on Presentation and Outcomes of Patients with Proximal Lower Extremity Deep Vein Thrombosis
dc.creator.none.fl_str_mv Bikdeli, Behnood
Sharif-Kashani, Babak
Bikdeli, Bavand
Valle, Reina
Falga, Conxita
Riera Mestre, Antoni
Mazzolai, Lucia
Verhamme, Peter
Wells, Philip S.
Sánchez Muñoz Torrero, Juan Francisco
López Jiménez, Luciano
Monreal, Manuel
RIETE investigadors
author Bikdeli, Behnood
author_facet Bikdeli, Behnood
Sharif-Kashani, Babak
Bikdeli, Bavand
Valle, Reina
Falga, Conxita
Riera Mestre, Antoni
Mazzolai, Lucia
Verhamme, Peter
Wells, Philip S.
Sánchez Muñoz Torrero, Juan Francisco
López Jiménez, Luciano
Monreal, Manuel
RIETE investigadors
author_role author
author2 Sharif-Kashani, Babak
Bikdeli, Bavand
Valle, Reina
Falga, Conxita
Riera Mestre, Antoni
Mazzolai, Lucia
Verhamme, Peter
Wells, Philip S.
Sánchez Muñoz Torrero, Juan Francisco
López Jiménez, Luciano
Monreal, Manuel
RIETE investigadors
author2_role author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Trombosi
Embòlia pulmonar
Thrombosis
Pulmonary embolism
topic Trombosi
Embòlia pulmonar
Thrombosis
Pulmonary embolism
description Small studies have suggested differences in demographics and outcomes between left- and right-sided deep vein thrombosis (DVT), and also unilateral versus bilateral DVT. We investigated the clinical presentation and outcomes of patients with DVT based on thrombus sidedness. The authors used the data from the Registro Informatizado Enfermedad TromboEmbólica (RIETE) database (2001-2016) to identify patients with symptomatic proximal lower-extremity DVT. Main outcomes included cumulative 90-day symptomatic pulmonary embolism (PE) and 1-year mortality. Overall, 30,445 patients were included. The majority of DVTs occurred in the left leg (16,421 left-sided, 12,643 right-sided, and 1,390 bilateral; p < 0.001 for chi-squared test comparing all three groups). Comorbidities were relatively similar in those with left-sided and right-sided DVT. Compared with those with left-sided DVT, patients with right-sided DVT had higher relative frequency of PE (26% versus 23%, p < 0.001) and 1-year mortality (odds ratio [OR]: 1.08; 95% confidence interval [CI]: 1.00-1.18). This difference in mortality did not persist after multivariable adjustment (OR: 1.01; 95% CI: 0.93-1.1). Patients with bilateral DVT had a greater burden of comorbidities such as heart failure, and recent surgery compared with those with unilateral DVT (p < 0.001), and higher relative frequency of PE (48%), and 1-year mortality (24.1%). Worse outcomes in patients with bilateral DVT were attenuated but persisted after multivariable adjustment for demographics and risk factors (OR: 1.64; 95% CI: 1.43-1.87). Patients with bilateral DVT had worse outcomes during and after discontinuation of anticoagulation. There is a left-sided preponderance for proximal lower-extremity DVT. Compared with those with left-sided DVT, patients with right-sided DVT have slightly higher rates of PE. Bilateral DVT is associated with markedly worse short-term and 1-year outcomes.
publishDate 2018
dc.date.none.fl_str_mv 2018
2020
2020
2020
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/acceptedVersion
format article
status_str acceptedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/2445/172460
url https://hdl.handle.net/2445/172460
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Versió postprint del document publicat a: https://doi.org/10.1055/s-0037-1621716
Seminars in Thrombosis and Hemostasis, 2018, vol. 44, num. 4, p. 341-347
https://doi.org/10.1055/s-0037-1621716
dc.rights.none.fl_str_mv (c) Thieme Medical Publishers, 2018
info:eu-repo/semantics/openAccess
rights_invalid_str_mv (c) Thieme Medical Publishers, 2018
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv 7 p.
application/pdf
dc.publisher.none.fl_str_mv Thieme Medical Publishers
publisher.none.fl_str_mv Thieme Medical Publishers
dc.source.none.fl_str_mv Articles publicats en revistes (Ciències Clíniques)
reponame:Recercat. Dipósit de la Recerca de Catalunya
instname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
instname_str Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
reponame_str Recercat. Dipósit de la Recerca de Catalunya
collection Recercat. Dipósit de la Recerca de Catalunya
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15,811543

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