Predictors of in-hospital mortality in elderly patients with acute venous thrombo-embolism: the SWIss Venous ThromboEmbolism Registry (SWIVTER).
OBJECTIVE
Although acute venous thrombo-embolism (VTE) often afflicts patients with advanced age, the predictors of in-hospital mortality for elderly VTE patients are unknown.


RESULTS
Among 1247 consecutive patients with acute VTE from the prospective SWIss Venous ThromboEmbolism Registry (SWIVTER), 644 (52%) were elderly (≥65 years of age). In comparison to younger patients, the elderly more often had pulmonary embolism (PE) (60 vs. 42%; P< 0.001), cancer (30 vs. 20%; P< 0.001), chronic lung disease (14 vs. 8%; P= 0.001), and congestive heart failure (12 vs. 2%; P< 0.001). Elderly VTE patients were more often hospitalized (75 vs. 52%; P< 0.001), and there was no difference in the use of thrombolysis, catheter intervention, or surgical embolectomy between the elderly and younger PE patients (5 vs. 6%; P= 0.54), despite a trend towards a higher rate of massive PE in the elderly (8 vs. 4%; P= 0.07). The overall in-hospital mortality rate was 6.6% in the elderly vs. 3.2% in the younger VTE patients (P= 0.033). Cancer was associated with in-hospital death both in the elderly [hazard ratio (HR) 4.91, 95% confidence interval (CI) 2.32-10.38; P< 0.001] and in the younger patients (HR 4.90, 95% CI 1.37-17.59; P= 0.015); massive PE was a predictor of in-hospital death in the elderly only (HR 3.77, 95% CI 1.63-8.74; P= 0.002).


CONCLUSIONS
Elderly patients had more serious VTE than younger patients, and massive PE was particularly life-threatening in the elderly.
Medical Affairs, Sanofi-Aventis (Suisse) SA, Meyrin,  Switzerland.
David
D
Spirk
Marc
M
Husmann
Daniel
D
Hayoz
Thomas
T
Baldi
Beat
B
Frauchiger
Rolf
R
Engelberger
Beatrice
B
Amann-Vesti
Iris
I
Baumgartner
Nils
N
Kucher
D000368:Aged; D000369:Aged, 80 and over; D058128:Compression Bandages / Q000706:statistics & numerical data; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011655:Pulmonary Embolism / Q000401:mortality / Q000628:therapy; D012008:Recurrence; D012042:Registries; D015424:Reperfusion / Q000401:mortality / Q000706:statistics & numerical data; D013557:Switzerland / Q000453:epidemiology; D017131:Thrombectomy / Q000401:mortality / Q000706:statistics & numerical data; D015912:Thrombolytic Therapy / Q000401:mortality / Q000706:statistics & numerical data; D016896:Treatment Outcome; D054556:Venous Thromboembolism / Q000401:mortality* / Q000628:therapy
D005343:Fibrinolytic Agents