title: Prior thromboprophylaxis and outcome in patients experiencing acute venous thromboembolism after an acute medical illness.
abstract: BACKGROUND
  Even despite the use of thromboprophylaxis, some patients with an acute medical illness develop symptomatic venous thromboembolism (VTE). It is unclear whether the outcome in these patients is different in those in whom prophylaxis was not prescribed.
  
  
  METHODS
  We used the RIETE (Registro Informatizado Enfermedad TromboEmbolica) database to compare the 3-month outcome (death, fatal pulmonary embolism, VTE recurrences, major bleeding) of patients with acute VTE after immobilization for an acute medical disease, according to the use of prophylaxis.
  
  
  RESULTS
  Thromboprophylaxis was prescribed in 1313 (37%) of the 3527 patients included in August 2014. Acute infection was the most frequent cause of immobilization. Patients who received prophylaxis were more frequently immobilized in hospital than at home (70% vs. 22%), and fewer patients were immobilized for cancer (13% vs. 22%). During the first 3months of treatment, the rates of all-cause death (23 vs. 21%), fatal PE (2.6 vs. 3.1%), VTE recurrences (2.4% vs. 2.8%), and major bleeding (4.2% for both) did not differ between the two groups. Thromboprophylaxis was not associated with each outcome in multivariate analysis.
  
  
  CONCLUSIONS
  The outcome in patients with VTE provoked by medical immobilization was not influenced by the use of thromboprophylaxis during the period of immobility.
authors.affiliation: INSERM, CIC1408, Saint-Etienne F-42055, France; INSERM, UMR1059, Equipe Dysfonction Vasculaire et Hémostase, Université Jean-Monnet, Saint-Etienne F-42055, France; CHU Saint-Etienne, Service de Médecine Vasculaire et Thérapeutique, Saint-Etienne F-42055, France; GIRC-Thrombose-INNOVTE network, Hôpital Nord, CHU de Saint-Etienne, Saint-Etienne F-42055, France. Electronic address: adel.merah@chu-st-etienne.fr.
authors.forename: Adel
authors.initials: A
authors.lastname: Merah
authors.affiliation: INSERM, CIC1408, Saint-Etienne F-42055, France; INSERM, UMR1059, Equipe Dysfonction Vasculaire et Hémostase, Université Jean-Monnet, Saint-Etienne F-42055, France; CHU Saint-Etienne, Service de Médecine Vasculaire et Thérapeutique, Saint-Etienne F-42055, France; GIRC-Thrombose-INNOVTE network, Hôpital Nord, CHU de Saint-Etienne, Saint-Etienne F-42055, France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Bertoletti
authors.affiliation: INSERM, CIC1408, Saint-Etienne F-42055, France; CHU Saint-Etienne, Service de Médecine Vasculaire et Thérapeutique, Saint-Etienne F-42055, France.
authors.forename: Mouzayan
authors.initials: M
authors.lastname: Ginzarly
authors.affiliation: Department of Internal Medicine, Tel Aviv Soursky Medical Center, Tel Aviv, Israel.
authors.forename: David
authors.initials: D
authors.lastname: Zeltser
authors.affiliation: Department of Pneumonology, Hospital San Pedro, Logroño, La Rioja, Spain.
authors.forename: Manuel
authors.initials: M
authors.lastname: Barrón
authors.affiliation: Department of Internal Medicine, Hospital General de Granollers, Barcelona, Spain.
authors.forename: Inmaculada
authors.initials: I
authors.lastname: Cañas
authors.affiliation: Department of Internal Medicine, Hospital Clinic, Barcelona, Spain.
authors.forename: Jaume
authors.initials: J
authors.lastname: Villalta
authors.affiliation: Department of Vascular Medicine, Azienda U.S.L. Di Ravenna-O.C. Di Faenza, Ravenna, Italy.
authors.forename: Eugenio
authors.initials: E
authors.lastname: Bucherini
authors.affiliation: Department of Internal Medicine, Hospital Universitario Germans Trias i Pujol de Badalona, Universidad Católica de Murcia, Spain.
authors.forename: Manuel
authors.initials: M
authors.lastname: Monreal
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D000208:Acute Disease / Q000453:epidemiology; D000925:Anticoagulants / Q000627:therapeutic use; D002423:Cause of Death; D006470:Hemorrhage / Q000453:epidemiology / Q000517:prevention & control; D007103:Immobilization / Q000009:adverse effects; D007391:International Cooperation; D011655:Pulmonary Embolism / Q000453:epidemiology / Q000517:prevention & control; D012008:Recurrence; D012042:Registries; D012044:Regression Analysis; D012307:Risk Factors; D016896:Treatment Outcome; D054556:Venous Thromboembolism / Q000453:epidemiology / Q000517:prevention & control
chemical_list: D000925:Anticoagulants
keywords: Anticoagulation; Outcome; Thromboprophylaxis; Venous thromboembolism