Age-Related Differences in the Presentation, Management, and Clinical Outcomes of 100,000 Patients With Venous Thromboembolism in the RIETE Registry

[Display omitted] Although older adults represent a significant proportion of patients with venous thromboembolism (VTE), the data on the impact of age-related differences in the clinical presentation, management, and outcomes of VTE are scarce. We analyzed data from the RIETE registry database, an...

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Published in:	Archivos de bronconeumología (English ed.) Vol. 60; no. 3; pp. 143 - 152
Main Authors:	Ortega, Alberto García, Pedro-Tudela, Ana, Pérez-Ductor, Cristina, Skride, Andris, Siniscalchi, Carmine, Adarraga, M.D., Amado, C., Ballaz, A., Barbagelata, C., Bascuñana, J., Blanco-Molina, A., De Ancos, C., Demelo-Rodríguez, P., De Juana-Izquierdo, C., Díaz-Brasero, A.M., Díaz-Peromingo, J.A., Dubois-Silva, A., Falgá, C., Farfán-Sedano, A.I., Fernández-Aracil, C., Fidalgo, M.A., Francisco, I., Gabara, C., Galeano-Valle, F., García-Ortega, A., Gavín-Sebastián, O., Gil De Gómez, M.A., Gil-Díaz, A., Gómez-Cuervo, C., Gutiérrez, J., Hernández-Blasco, L., Jiménez, D., Jou, I., Joya, M.D., Lainez-Justo, S., Lobo, J.L., López-Miguel, P., Madridano, O., Maestre, A., Martín del Pozo, M., Mena, E., Mercado, M.I., Moisés, J., Monreal, M., Olid, M., Ordieres-Ortega, L., Ortiz, M., Otero, R., Palomeque, A.C., Paredes, E., Parra-Rosado, P., Pérez-Pinar, M., Porras, J.A., Rosa, V., Salgueiro, G., Sancho, T., Sendín, V., Sigüenza, P., Soler, S., Suárez-Fernández, S., Trujillo-Santos, J., Uresandi, F., Varona, J.F., Villares, P., Ay, C., Vanassche, T., Verhamme, P., Yoo, H.H.B., Montenegro, A.C., Roa, J., Malý, R., Catella, J., Couturaud, F., Espitia, O., Grange, C., Moustafa, F., Sarlon-Bartoli, G., Schellong, S., Brenner, B., Tzoran, I., Rashidi, F., Abenante, A., Barillari, G., Bilora, F., Bortoluzzi, C., Colaizzo, D., Dentali, F., Di Micco, P., Lambertenghi-Deliliers, D., Poz, A., Siniscalchi, C., Paluga, R., Kigitovica, D., Fonseca, S., Marques, R., Pinto, S., Trajkova, M., Aujayeb, A., Caprini, J.A., Bui, H.M.
Format:	Journal Article
Language:	English
Published:	Spain Elsevier España, S.L.U 01-03-2024
Subjects:	Anticoagulation Bleeding Mortality Pulmonary embolism Recurrences Venous thromboembolism ECMO DVT OR CI VTE Mortality sPESI NMCR Anticoagulation DOAC VKA Bleeding Recurrences Pulmonary embolism CT LMWH SD PE IVC RIETE Venous thromboembolism
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Summary:	[Display omitted] Although older adults represent a significant proportion of patients with venous thromboembolism (VTE), the data on the impact of age-related differences in the clinical presentation, management, and outcomes of VTE are scarce. We analyzed data from the RIETE registry database, an ongoing global observational registry of patients with objectively confirmed VTE, to compare patient characteristics, clinical presentation, treatments, and outcomes between elderly (≥70 years) vs. non-elderly (<70 years) patients. From January 2001 to March 2021, 100,000 adult patients were enrolled in RIETE. Elderly patients (47.9%) were more frequently women (58.2% vs. 43.5%), more likely had unprovoked VTE (50.5% vs. 45.1%) and most often presented with severe renal failure (10.2% vs. 1.2%) and acute pulmonary embolism (PE) (vs. deep vein thrombosis) (54.3% vs. 44.5%) compared to non-elderly patients (p<0.001 for all comparisons). For the PE subgroup, elderly patients more frequently had non-low risk PE (78.9% vs. 50.7%; p<0.001), respiratory failure (33.9% vs. 21.8%; p<0.001) and myocardial injury (40.0% vs. 26.2%; p<0.001) compared to non-elderly patients. Thrombolysis (0.9% vs. 1.7%; p<0.001) and direct oral anticoagulants (8.8% vs. 11.8%; p<0.001) were less frequently administered to elderly patients. Elderly patients showed a significantly higher 30-day all-cause mortality (adjusted odds ratio [OR] 1.36, 95%CI: 1.22–1.52) and major bleeding (OR, 2.08; 95%CI, 1.85–2.33), but a lower risk of 30-day VTE recurrences (OR, 0.62, 95%CI, 0.54–0.71). Compared with non-elderly patients, elderly patients had a different VTE clinical profile. Advanced therapies were less frequently used in older patients. Age was an independent predictor of mortality.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0300-2896 1579-2129
DOI:	10.1016/j.arbres.2023.12.016