title: Mortality and recurrence after treatment of VTE: long term follow-up of patients with good life-expectancy.
abstract: BACKGROUND
  After completed anticoagulant treatment for acute VTE, both the subsequent mortality and risk of recurrent VTE are high, probably related to the frequent presence of serious disease in these patients. The aim of the study was to determine survival and recurrence in selected patients with good life-expectancy, and to evaluate risk factors.
  
  
  METHODS
  The 323 patients were followed for median 7.4 years (range 4.1-11.9) after cessation of anticoagulation. Survival analysis and Cox-regression were used for univariate and multivariate analysis.
  
  
  RESULTS
  The cumulative incidence of survival after 5 years was 93.4%. Standardised mortality ratio was 1.42 for men and 1.28 for women. Patients without a transient risk factor prior to the index VTE were associated with higher risk of mortality compared to risk of mortality in patients with a transient risk factor (hazard ratio (HR) 2.81; 95% CI 1.40-5.62). Recurrence of VTE after 5 years was 19.0%. A persistent risk factor or a spontaneous VTE was associated with higher risk of recurrence compared to a transient risk factor (HR 2.39; 95% CI 1.44-3.95). Elevated D-dimer levels increased the risk, and immobilisation prior to the index VTE reduced the risk of recurrence. Sex, age and thrombophilia were not independent risk factors for recurrence.
  
  
  CONCLUSIONS
  Despite a low mortality rate in this selected cohort, the recurrence rate and risk factors for recurrence were similar to findings reported in unselected populations. VTE unrelated to a transient risk factor was associated with increased mortality compared to mortality in patients with a transient risk factor.
authors: Oslo University Hospital, Aker, Norway. m.s.andresen@medisin.uio.no
authors: Marianne S
authors: MS
authors: Andresen
authors: Irene
authors: I
authors: Sandven
authors: Cathrine
authors: C
authors: Brunborg
authors: Anne Mette
authors: AM
authors: Njaastad
authors: Finn
authors: F
authors: Strekerud
authors: Michael
authors: M
authors: Abdelnoor
authors: Pål
authors: P
authors: Smith
authors: Ulrich
authors: U
authors: Abildgaard
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008017:Life Expectancy; D008297:Male; D008875:Middle Aged; D009664:Norway / Q000453:epidemiology; D011446:Prospective Studies; D012008:Recurrence; D012307:Risk Factors; D012737:Sex Factors; D016019:Survival Analysis; D054556:Venous Thromboembolism / Q000097:blood / Q000188:drug therapy* / Q000401:mortality*; D014859:Warfarin / Q000008:administration & dosage; D055815:Young Adult
chemical_list: D014859:Warfarin