Abstract 16875: Mortality Rates Among Patients With Venous Thromboembolism on Anticoagulant Therapy
Background: Venous thromboembolism (VTE), comprising deep vein thrombosis (DVT) and pulmonary embolism (PE), is associated with significant morbidity and mortality. The prognosis for patients who develop DVT or PE is directly related to the risk of recurrent events and other complications, such as bleeding. These complications, along with patient-specific factors, may result in additional mortality risk.
Objectives: To determine the rate of all-cause mortality during follow-up based on the type (cancer provoked, surgery/pregnancy/oral contraception-provoked, or unprovoked) of DVT and PE.
Methods: A large US claims database was used to identify patients who had DVT or PE, ≥1 anticoagulant prescription, and were linked to the Social Security Administration file from 7/1/2006 to 7/31/2013. All patients were ≥18 years old, had continuous database enrollment and no VTE or anticoagulant use in the 6 months preceding the index diagnosis of VTE. All patients were followed until death or end of study. Bleeding and recurrent VTE were assessed separately for DVT and PE; all-cause mortality was further assessed according to type of VTE. Bleeding was defined as occurring in a critical site. Recurrent VTE was defined as hospitalization with VTE as the primary discharge diagnosis or re-initiation of anticoagulation treatment after a 60-day gap.
Results: Of 108,184 patients, 62% had DVT and 38% PE (Table). Of all VTE, 20% were classified as cancer-provoked, 20% as surgery/pregnancy/contraception-provoked, and 60% as unprovoked. Recurrent VTE and bleeding event rates were similar between patients with DVT and PE. Patients with VTE provoked by cancer had the highest mortality rates.
Conclusions: Recurrent VTE and bleeding was common after an index event in this large patient database, and all-cause mortality was considerable, particularly in cancer patients. Our work underscores the importance of physician awareness of risk factors that influence a patient’s outcome after VTE.
Author Disclosures: E. Nutescu: None. X. Song: None. B. Bookhart: Employment; Significant; Janssen Scientific Affairs, LLC. Ownership Interest; Significant; Johnson & Johnson. N. Shi: None. M. Raut: Employment; Significant; Janssen Scientific Affairs, LLC. Ownership Interest; Significant; Johnson & Johnson. C.V. Damaraju: Employment; Significant; Janssen Scientific Affairs, LLC. J. Schein: Employment; Significant; Janssen Scientific Affairs, LLC. Ownership Interest; Significant; Johnson & Johnson. S. Kaatz: Speakers Bureau; Modest; CSL Behring. Speakers Bureau; Significant; Janssen/Johnson and Johnson, Boehringer-Ingelheim, Bristol Myer Squibb/Pfizer. Consultant/Advisory Board; Modest; Bristol Myer Squibb/Pfizer, Daiichi Sankyo. Consultant/Advisory Board; Significant; Boehringer-Ingelheim, Janssen/Johnson and Johnson.
- © 2014 by American Heart Association, Inc.