New
Service for TodaysSeniorsNetwork.com
readers...roll mouse over, click on
highlighted links in stories to review items
from Amazon
Now, keep up to date
with daily feeds of newly posted stories
about America's Seniors...click on the box
to the left
Long-Term
outcomes following Blood Clots
Newswise — Patients who develop a blood clot
in their legs (deep vein thrombosis) or
lungs (pulmonary embolism) are at risk for
experiencing another blood clot within three
years, and patients with pulmonary embolism
have a higher risk of death, according to a
report in the February 25 issue of Archives
of Internal Medicine, one of the JAMA/Archives
journals.
Deep vein thrombosis and pulmonary embolism
are considered different manifestations of
the same disease process, according to
background information in the article.
The medical management of both conditions,
known collectively as venous thromboembolism,
has improved in the past decade, the authors
note.
Frederick A. Spencer, M.D., of McMaster
University Medical Center, Hamilton,
Ontario, Canada, and colleagues analyzed the
medical records of 1,691 Worcester, Mass.,
residents (54 percent women, average age 65)
who were diagnosed with venous
thromboembolism in 1999, 2001 or 2003.
Of those, 549 had pulmonary embolism and
1,142 had isolated deep vein thrombosis.
Over the three-year study, among the 549
patients who presented with pulmonary
embolism, 31 (5.7 percent) had a recurrent
clot in the lung, 75 (13.7 percent) had a
recurrence of either type of venous
thromboembolism and 82 (14.9 percent)
experienced a major bleeding episode (i.e.,
so severe they required a transfusion).
Among the 1,142 patients who presented with
isolated deep vein thrombosis over the same
period, 64 (5.6 percent) developed a
pulmonary embolism, 217 (19 percent) had
recurrent venous thromboembolism and 146
(12.8 percent) had a major bleeding episode.
Individuals with pulmonary embolism were
more likely to die after one month (13
percent vs. 5.4 percent), one year (26
percent vs. 20.3 percent) and three years
(35.3 percent vs. 29.6 percent) than those
with deep vein thrombosis.
“Patients
whose course was complicated by major
bleeding were more likely to experience
recurrent venous thromboembolism or to die
at three years than those without these
complications,” the authors write.
“Patients who presented with pulmonary
embolism had similar rates of subsequent
pulmonary embolism or recurrent venous
thrombosis compared with patients with
isolated deep vein thrombosis,” the authors
conclude.
“However,
rates of recurrent venous thromboembolism
and major bleeding after deep vein
thrombosis and pulmonary embolism remain
unacceptably high in the community setting.
"Efforts
are needed to identify patients most at risk
for venous thrombosis–associated
complications and to develop better
anticoagulation strategies conducive to
long-term use in the community setting.”
(Arch Intern Med. 2008;168[4]:425-430.
Available pre-embargo to the media at
www.jamamedia.org.)
Editor’s Note: This study was supported by a
grant from the National Heart, Lung and
Blood Institute. Dr. Spencer has also
received a Career Investigator Award from
the Heart and Stroke Foundation of Canada.
Please see the article for additional
information, including other authors, author
contributions and affiliations, financial
disclosures, funding and support, etc.
...
...
...