CTU Bern (Clinical Trials Unit)

New study published: Predictors and outcomes of recurrent venous thromboembolism in elderly patients

The study was conducted between September 2009 and December 2013 as part of a prospective multicenter cohort study, the Swiss Venous Thromboembolism Cohort Study 65+, that assessed long-term medical outcomes and quality of life in elderly patients with symptomatic venous thromboembolism from all five university and four high-volume non-university hospitals in Switzerland. 
Under the lead of Prof. Drahomir Aujesky, head of the Division for General Internal Medicine of the Inselspital, Bern University Hospital, the cohort study has received funding from the Swiss National Science Foundation SNSF. The Data Management as well as the Statistics & Methodology divisions of CTU Bern have collaborated with the investigators throughout the study: from study setup and initiation (methodological support and data base setup) to data analysis and publication writing.
The aim of the study was to gain new insights on the predictors and outcomes of recurrent venous thromboembolism in elderly patients, a before modestly researched topic. Between 2009 and 2013, the investigators followed up 991 patients aged ≥65 years with acute venous thromboembolism. The defined primary outcome was symptomatic recurrent venous thromboembolism. The collaborators have studied the association between baseline characteristics, treatments and recurrent venous thromboembolism. To this end, a competing risk regression was performed and additionally, the clinical consequences (case-fatality, localization) of recurrent venous thromboembolism were assessed.
Of the 991, 122 patients developed recurrent venous thromboembolism during the median follow-up period of 30 months. This corresponds to a 3-year cumulative incidence of 14.8%. The case-fatality of recurrence was high (20.5%): especially in patients with unprovoked (23%) and cancer-related venous thromboembolism (29%). After adjustment, only unprovoked venous thromboembolism as well as proximal deep vein thrombosis were found to be significantly associated with recurrence.
The results thus indicate that traditional risk factors for venous thromboembolism recurrence, such as cancer or sex, may be less relevant in the elderly.

Sandro Lauber, Andreas Limacher, Tobias Tritschler, Odile Stalder, Marie Méan, Marc Righini, Markus Aschwanden, Jürg Hans Beer, Beat Frauchiger, Josef Osterwalder, Nils Kucher, Bernhard Lämmle, Jacques Cornuz, Anne Angelillo-Scherrer, Christian M. Matter, Marc Husmann, Martin Banyai, Daniel Staub, Lucia Mazzolai, Olivier Hugli, Nicolas Rodondi, Drahomir Aujesky, Predictors and Outcomes of Recurrent Venous Thromboembolism in Elderly Patients, The American Journal of Medicine (2018), https://doi.org/10.1016/j.amjmed.2017.12.015.

Link to article on PubMed.gov: https://www.ncbi.nlm.nih.gov/pubmed/29307536