title: Comparisons Between Upper and Lower Extremity Deep Vein Thrombosis: A Review of the RIETE Registry.
abstract: BACKGROUND
  The outcome of patients with upper extremity deep vein thrombosis (UEDVT) has not been consistently compared with that in patients with lower extremity deep vein thrombosis (LEDVT).
  
  
  METHODS
  We used the Registro Informatizado de Enfermedad Trombo Embólica (RIETE) registry to compare the outcomes during the course of anticoagulant therapy in patients with UEDVT versus outcomes in patients with LEDVT.
  
  
  RESULTS
  As of August 2015, 37,366 patients with acute DVT had been enrolled in RIETE: 35094 (94%) had LEDVT, 1334 (3.6%) non-catheter related UEDVT (672 unprovoked and 662 provoked) and 938 (2.5%) had catheter-related UEDVT. During the course of anticoagulation, patients with unprovoked UEDVT had a higher rate of DVT recurrences (hazard ratio [HR]: 2.22; 95% CI: 1.37-3.43) and a similar rate of PE recurrences or major bleeding than those with unprovoked LEDVT. Patients with non-catheter-related provoked UEDVT had a similar outcome than those with provoked LEDVT. Among patients with UEDVT, those with non-catheter related unprovoked UEDVT had a lower rate of PE recurrences (HR: 0.06; 95% CI: 0-0.35) and major bleeding (HR: 0.20; 95% CI: 0.08-0.46) than those with catheter-related UEDVT or those with non-catheter related provoked UEDVT (HR: 0.10; 95% CI: 0.004-0.60; and 0.22; 95% CI: 0.08-0.52, respectively). On multivariable analysis, any difference had disappeared.
  
  
  CONCLUSIONS
  During the course of anticoagulation, patients with UEDVT had a similar outcome than those with LEDVT. Among UEDVT patients, there were some differences according to the presence of catheter or additional risk factors for DVT. These differences disappeared after adjusting for potentially confounding variables.
authors: 1 Department of Nursing/Critical Care, Evanston Hospital, NorthShore University HealthSystem, Evanston, IL, USA.
authors: Lauren P
authors: LP
authors: Cote
authors: 2 Department of Anesthesia/Critical Care, Evanston Hospital, NorthShore University HealthSystem, Chicago, IL, USA.
authors: Steven
authors: S
authors: Greenberg
authors: 3 Division of Vascular Surgery, Evanston Hospital, NorthShore University HealthSystem, Chicago, IL, USA.
authors: Joseph A
authors: JA
authors: Caprini
authors: 3 Division of Vascular Surgery, Evanston Hospital, NorthShore University HealthSystem, Chicago, IL, USA.
authors: Alfonso
authors: A
authors: Tafur
authors: 4 Department of Anesthesiology, Yale-New Haven Hospital, New Haven, CT, USA.
authors: Chris
authors: C
authors: Choi
authors: 5 Department of Internal Medicine, Fundació Privada Hospital de Mollet, Barcelona, Spain.
authors: Francisco J
authors: FJ
authors: Muñoz
authors: 6 Department of Cardiology, Ospedale Pauls Stradins Clinical University Hospital, Riga, Latvia.
authors: Andris
authors: A
authors: Skride
authors: 7 Department of Internal Medicine, Hospital General Universitario de Alicante, Alicante, Spain.
authors: Beatriz
authors: B
authors: Valero
authors: 8 Department of Internal Medicine, Hospital Universitario Joan XXIII de Tarragona, Tarragona, Spain.
authors: José Antonio
authors: JA
authors: Porras
authors: 9 Department of Emergency Internal Medicine, Ospedale St John, Rome, Italy.
authors: Maurizio
authors: M
authors: Ciammaichella
authors: 10 Department of Pneumonology, Hospital General Universitario de Alicante, Alicante, Spain.
authors: Luis Manuel
authors: LM
authors: Hernández-Blasco
authors: 11 Department of Internal Medicine, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain.
authors: Manuel
authors: M
authors: Monreal
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000627:therapeutic use; D057785:Catheters / Q000009:adverse effects; D005260:Female; D006470:Hemorrhage / Q000209:etiology; D006801:Humans; D035002:Lower Extremity / Q000098:blood supply / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000209:etiology; D012008:Recurrence; D012042:Registries; D016896:Treatment Outcome; D034941:Upper Extremity / Q000098:blood supply / Q000473:pathology*; D020246:Venous Thrombosis / Q000150:complications / Q000473:pathology*
chemical_list: D000925:Anticoagulants
keywords: anticoagulant therapy; bleeding; catheter; deep vein thrombosis; lower extremity; pulmonary embolism; recurrences; upper extremity