Abstract
Limited data are available regarding long-term survival following venous thromboembolism (VTE). The objectives of this study are to evaluate long-term survival by retrospective survival analysis in patients with a history of VTE and to compare their survival with that of the general population. Patients with a history of VTE (min. 3 months after VTE) without cancer, who were referred to our department between 1994 and 2007, were included in the analysis. Information concerning mortality was available through the Austrian Central Death Register. The survival of patients was compared with that of the age- and gender-matched general Austrian population. Three thousand two hundred-nine patients (mean age, 46.2; range, 14–89 years) were included. Median time interval between the first VTE and inclusion was 14 months; median observation period was 6.6 years. During the considered time period, 169 patients (5.3%) died. The cumulative survival in patients was 0.97 and 0.87 after 5 and 10 years; men had a higher death rate than women; patients with idiopathic VTE had a less favourable survival than those with a triggering event. When patients were compared to the general population, the cumulative relative survival was 1.02 (95% CI 1.00–1.03). In none of the analysed subgroups (different sites of VTE; idiopathic vs. secondary VTE) was a reduced cumulative relative survival found. The relative survival of male patients was even slightly better, whereas that of women equalled that of the normal population. Our results indicate that after the initial phase, VTE does not seem to impair long-term survival of patients with a history of VTE without cancer.
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References
Palareti G, Cosmi B (2004) Predicting the risk of recurrence of venous thromboembolism. Curr Opin Hematol 11:192–197
Anderson FA Jr, Wheeler HB, Goldberg RJ, Hosmer DW, Patwardhan NA, Jovanovic B, Forcier A, Dalen JE (1991) A population-based perspective of the hospital incidence and case-fatality rates of deep vein thrombosis and pulmonary embolism. The Worcester DVT Study. Arch Intern Med 151:933–938
Nordstrom M, Lindblad B, Bergqvist D, Kjellstrom T (1992) A prospective study of the incidence of deep-vein thrombosis within a defined urban population. J Intern Med 232:155–160
Kyrle PA, Minar E, Bialonczyk C, Hirschl M, Weltermann A, Eichinger S (2004) The risk of recurrent venous thromboembolism in men and women. N Engl J Med 350:2558–2563
Kyrle PA, Eichinger S (2005) Deep vein thrombosis. Lancet 365:1163–1174
Schulman S, Lindmarker P, Holmstrom M, Larfars G, Carlsson A, Nicol P, Svensson E, Ljungberg B, Viering S, Nordlander S, Leijd B, Jahed K, Hjorth M, Linder O, Beckman M (2006) Post-thrombotic syndrome, recurrence, and death 10 years after the first episode of venous thromboembolism treated with warfarin for 6 weeks or 6 months. J Thromb Haemost 4:734–742
Eichinger S, Weltermann A, Minar E, Stain M, Schonauer V, Schneider B, Kyrle PA (2004) Symptomatic pulmonary embolism and the risk of recurrent venous thromboembolism. Arch Intern Med 164:92–96
Garcia-Fuster MJ, Forner MJ, Fernandez C, Gil J, Vaya A, Maldonado L (2005) Long-term prospective study of recurrent venous thromboembolism in patients younger than 50 years. Pathophysiol Haemost Thromb 34:6–12
Kniffin WD Jr, Baron JA, Barrett J, Birkmeyer JD, Anderson FA Jr (1994) The epidemiology of diagnosed pulmonary embolism and deep venous thrombosis in the elderly. Arch Intern Med 154:861–866
Naess IA, Christiansen SC, Romundstad P, Cannegieter SC, Rosendaal FR, Hammerstrom J (2007) Incidence and mortality of venous thrombosis: a population-based study. J Thromb Haemost 5:692–699
Douketis JD, Gu CS, Schulman S, Ghirarduzzi A, Pengo V, Prandoni P (2007) The risk for fatal pulmonary embolism after discontinuing anticoagulant therapy for venous thromboembolism. Ann Intern Med 147:766–774
Flinterman LE, van Hylckama Vlieg A, Rosendaal FR, Doggen CJ (2008) Recurrent thrombosis and survival after a first venous thrombosis of the upper extremity. Circulation 118:1366–72
Heit JA, Silverstein MD, Mohr DN, Petterson TM, O'Fallon WM, Melton LJ III (1999) Predictors of survival after deep vein thrombosis and pulmonary embolism: a population-based, cohort study. Arch Intern Med 159:445–453
Statistics Austria (2010) Statistics Austria (internet communication). http://www.statistik.at/web_en. Accessed 20-6-2010
Kaplan EL, Meier P (1958) Nonparametric-estimation from incomplete observations. J Am Stat Assoc 53:457–481
Dickman PW, Sloggett A, Hills M, Hakulinen T (2004) Regression models for relative survival. Stat Med 23:51–64
Dickman P (2010) Estimating and modelling relative survival using SAS (internet communication). http://www.pauldickman.com/rsmodel/sas_colon/. Accessed 1-12-2009
Statistics Austria (2010) Austrian micro census (internet communication). http://www.statistik.at/web_en/statistics/health/health_care/outpatient_care/index.html. Accessed 20-6-2010
Schulman S, Lindmarker P, Johnsson H (1995) Influence of changes in lifestyle on fibrinolytic parameters and recurrence rate in patients with venous thromboembolism. Blood Coagul Fibrinolysis 6:311–316
Heit JA, Silverstein MD, Mohr DN, Petterson TM, Lohse CM, O'Fallon WM, Melton LJ III (2001) The epidemiology of venous thromboembolism in the community. Thromb Haemost 86:452–463
Ridker PM, Goldhaber SZ, Danielson E, Rosenberg Y, Eby CS, Deitcher SR, Cushman M, Moll S, Kessler CM, Elliott CG, Paulson R, Wong T, Bauer KA, Schwartz BA, Miletich JP, Bounameaux H, Glynn RJ, Ridker PM, Glynn RJ, Danielson EM, Bates D, Christen W, DeFonce P, Griffin W, Jackson F, Murray A, Taylor K, Johnson K, McKenna K, Pierre J, Holman B, Dessources F, Quinn P, Laurinaitis T, MacFadyen J, Eby C, Miletich JP, Porche-Sorbet R, Goldhaber SZ, Morrison RB, MacDougall RC, Morrison RM, Lamas G, Bailey K, Gersh B, Pellegrino E, Rick M, Vaughan D, Rosenberg Y, Goldhaber SZ, Morrison RB, MacDougall RC, Morrison RM, Deitcher SR, Olin J, Sulzer S, Cushman M, Cohen R, Moll S, Jones S, Kessler CM, Lee A, Elliott CG, Kitterman N, Jafri S, Wulbrecht N, Bauer K, Mahony M, Paulson R, Vold D, Wong T, Erickson-Nesmith S, Bounameaux H, de Lucia S, Chagnon I, Schwartz B, Thackery R, Gates N, Nguyen P, Paris S, LeCours B, Oliver M, Hodapp K, Grad G, Bank B, Rindels J, Leano C, Haire W, O'Grady D, Schneider J, Key N, Christie B, Blostein M, Strulovitch C, Usedom J, Oskins D, Eby C, Lee V, Heuerman S, Kerins D, Roberts B, White R, Castro E, Riddle E, Ingram M, Becker RC, Emery C, Wong L, Dent S, Comp P, Havarda D, Galichia JP, Terry L, Waldren S, Hambleton J, Pineo G, Hull R, Sheldon J, Tsapatsaris N, Woodhead G, Mann M, Welsh C, Schoch T, Goldsmith J, Anthony T, Walters J, Caprini J, Maher ML, Medica K, Rabbitt S, Finocchio J, Keaton K, Lee H, McLean S, Barban K, Mohler E, Medenilla E, Wolfe M, de Lemos A, Rubenfire M, McDevitt S, Housholder S, Siegel JE, Bradley B, Brophy M, Reilly C, Brown E, Valeria A, Rodriguez L, Kumar A, Pekron J, Wagner J, Richart J, Jones J, Weber V, Fellin C, Sim J, Graham M, Sutton D, Tezcan H, Herbst S, Waldrum M, Meadows T, Carlson W, Welch-Costantino M, Gosset J, Nonnweiler J, Kumar A, Green K, Tapson V, Krichman A, Yeo E, Boross-Harmer S (2003) Long-term, low-intensity warfarin therapy for the prevention of recurrent venous thromboembolism. N Engl J Med 348:1425–1434
White RH, Zhou H, Murin S (2008) Death due to recurrent thromboembolism among younger healthier individuals hospitalized for idiopathic pulmonary embolism. Thromb Haemost 99:683–690
Acknowledgements
We thank Tanja Altreiter, MA (Clinical Division of Haematology and Haemostaseology, Department of Medicine I, Medical University Vienna) for proofreading of the manuscript.
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Dr. Reitter is recipient of a Bayer Haemophilia Clinical Training Award.
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Reitter, S.E., Waldhoer, T., Mayerhofer, M. et al. Long-term survival of patients with a history of venous thromboembolism. Ann Hematol 90, 585–594 (2011). https://doi.org/10.1007/s00277-011-1160-0
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DOI: https://doi.org/10.1007/s00277-011-1160-0