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1. Predicting the risk of osteoporosis in older Vietnamese women using machine learning approaches

Author

Hanh My Bui, Minh Hoang Ha, Hoang Giang Pham, Thang Phuoc Dao, Thuy-Trang Thi Nguyen, Minh Loi Nguyen, Ngan Thi Vuong, Xuyen Hong Thi Hoang, Loc Tien Do, Thanh Xuan Dao, and Cuong Quang Le

Subjects
Medicine, Science
Abstract

Abstract Osteoporosis contributes significantly to health and economic burdens worldwide. However, the development of osteoporosis-related prediction tools has been limited for lower-middle-income countries, especially Vietnam. This study aims to develop prediction models for the Vietnamese population as well as evaluate the existing tools to forecast the risk of osteoporosis and evaluate the contribution of covariates that previous studies have determined to be risk factors for osteoporosis. The prediction models were developed to predict the risk of osteoporosis using machine learning algorithms. The performance of the included prediction models was evaluated based on two scenarios; in the first one, the original test parameters were directly modeled, and in the second the original test parameters were transformed into binary covariates. The area under the receiver operating characteristic curve, the Brier score, precision, recall and F1-score were calculated to evaluate the models’ performance in both scenarios. The contribution of the covariates was estimated using the Permutation Feature Importance estimation. Four models, namely, Logistic Regression, Support Vector Machine, Random Forest and Neural Network, were developed through two scenarios. During the validation phase, these four models performed competitively against the reference models, with the areas under the curve above 0.81. Age, height and weight contributed the most to the risk of osteoporosis, while the correlation of the other covariates with the outcome was minor. Machine learning algorithms have a proven advantage in predicting the risk of osteoporosis among Vietnamese women over 50 years old. Additional research is required to more deeply evaluate the performance of the models on other high-risk populations.

Published
2022
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2. Heart Rate and Mortality in Patients With Acute Symptomatic Pulmonary Embolism

Author

G. Pellejero, Jose Gutierrez, R. Malý, M. Basaglia, L. Chasco, P. Suchon, R. Le Mao, Laurent Bertoletti, F. Martins, J. Caprini, A. Braester, F. Galeano-Valle, Hanh My Bui, J. Alonso, Y. Sato, G. Vidal, Y. Nishimoto, C. Tolosa, E. Nofuentes-Pérez, A.M. Díaz-Brasero, N. Ait Abdallah, M.D. Adarraga, R. Sánchez-Martínez, L. Font, Raquel López-Reyes, Inna Tzoran, Karine Lacut, J. del Toro, Andris Skride, Ana Jaureguizar, Joseph A. Caprini, C. Amado, R. García de la Garza, A.M. Camon, S. Merla, Luciano López-Jiménez, G. Salgueiro, Sebastian Schellong, Alfonso Muriel, F. Bilora, S. Lainez-Justo, B. Suárez-Rodríguez, Carme Font, F. Beddar Chaib, I. Francisco, C. Jiménez-Alfaro, P. Azcarate-Agüero, Maurizio Ciammaichella, J.A. Porras, N. Vo Hong, F. Martín-Martos, Dominique Farge-Bancel, D. Farge-Bancel, José Luis Lobo, M. Giménez-Suau, E. Grau, F. García-Bragado, Ángeles Blanco-Molina, Carmen Fernández-Capitán, María del Carmen Díaz-Pedroche, C. Grange, Adriana Visonà, L. Guirado, P. Villares, P. López-Miguel, José María Pedrajas, S. Accassat, Beatriz Valero, B. Crichi, Juan J. López-Núñez, Luis Jara-Palomares, G. Sarlon-Bartoli, J. Lima, C. Bortoluzzi, Alicia Lorenzo, C. de Ancos, M.A. Fidalgo, Philippe Debourdeau, Pablo Javier Marchena, C. Rodríguez-Matute, A.I. Farfán-Sedano, José Luis Fernández-Reyes, J.C. Escribano, Juan I. Arcelus, M. Barrón, I. Quere, Remedios Otero, A. De Angelis, P. Morange, Peter Verhamme, G. Kenet, P. Prandoni, Pedro Ruiz-Artacho, C. Siniscalchi, A. Zaicenko, M. Olid-Velilla, C. García-Díaz, B. Barrón-Andrés, T. Sancho, Fernando Uresandi, Javier Trujillo-Santos, A. Muñoz-Blanco, A. Villalobos, A. Dubois-Silva, J. Moisés, J. Osorio, M.I. Mercado, J.M. Suriñach, M.A. Aibar, M.D. Joya, Cihan Ay, J.A. Díaz-Peromingo, H. Bounameaux, Diego Martínez-Urbistondo, Thomas Vanassche, L. Bertoletti, Marijan Bosevski, Farès Moustafa, M. Martín del Pozo, J.F. Sánchez-Muñoz-Torrero, H.M. Bui, Ingrid Pabinger, M.C. Olivares, M. García de Herreros, M.J. Núñez-Fernández, B. Zalunardo, J.F. Varona, Stephan Nopp, Behnood Bikdeli, B. Brandolin, B. Bikdeli, Olga Madridano, Manuel Monreal, M.J. Jaras, Alessandra Bura-Rivière, Abílio Reis, J. Portillo, O. Espitia, J. Catella, Aitor Ballaz, F. Esposito, R. Barba, R. Valle, H. Helfer, I. Tzoran, J.B. López-Sáez, P. Ruiz-Artacho, M.A. García, J. Aibar, C. Gómez-Cuervo, C. Gabara, A. Latorre, J. Ruiz-Ruiz, Benjamin Brenner, S. Fonseca, S. Schellong, Raffaele Pesavento, Barry M. Brenner, Silvia Soler, Paolo Prandoni, Victor F. Tapson, Ana Maestre, Pierpaolo Di Micco, M. Muñoz, J. Criado, D. Jiménez, Antonella Tufano, G. Krstevski, B. Valero, Henri Bounameaux, M.I. Torres, G. Poenou, Isabelle Mahé, Aída Gil-Díaz, A. Asuero, S. Otalora, V. Rosa, L. Vela, E. Imbalzano, C. Vandenbriele, C. Barbagelata, Jana Hirmerova, J. Meireles, David Jiménez, Lucia Mazzolai, L. Hernández-Blasco, M. Bosevski, Gili Kenet, C. Mella, M. Monreal, J.R. Vela, P. Di Micco, Carlos Zamora, K. Flores, P. Demelo-Rodríguez, Radovan Malý, J. Birzulis, J.A. Nieto, J. Castro, M.V. Di Campli, Francis Couturaud, Raquel Barba, Jaureguizar, A., Jimenez, D., Bikdeli, B., Ruiz-Artacho, P., Muriel, A., Tapson, V., Lopez-Reyes, R., Valero, B., Kenet, G., Monreal, M., Prandoni, P., Brenner, B., Farge-Bancel, D., Barba, R., Di Micco, P., Bertoletti, L., Schellong, S., Tzoran, I., Reis, A., Bosevski, M., Bounameaux, H., Maly, R., Verhamme, P., Caprini, J. A., Bui, H. M., Adarraga, M. D., Aibar, J., Aibar, M. A., Alonso, J., Amado, C., Arcelus, J. I., Asuero, A., Azcarate-Aguero, P., Ballaz, A., Barbagelata, C., Barron, M., Barron-Andres, B., Blanco-Molina, A., Beddar Chaib, F., Camon, A. M., Castro, J., Chasco, L., Criado, J., de Ancos, C., del Toro, J., Demelo-Rodriguez, P., Diaz-Brasero, A. M., Diaz-Pedroche, M. C., Diaz-Peromingo, J. A., Di Campli, M. V., Dubois-Silva, A., Escribano, J. C., Esposito, F., Farfan-Sedano, A. I., Fernandez-Capitan, C., Fernandez-Reyes, J. L., Fidalgo, M. A., Flores, K., Font, C., Font, L., Francisco, I., Gabara, C., Galeano-Valle, F., Garcia, M. A., Garcia-Bragado, F., Garcia de Herreros, M., Garcia de la Garza, R., Garcia-Diaz, C., Gil-Diaz, A., Gomez-Cuervo, C., Gimenez-Suau, M., Grau, E., Guirado, L., Gutierrez, J., Hernandez-Blasco, L., Jara-Palomares, L., Jaras, M. J., Jimenez-Alfaro, C., Joya, M. D., Lainez-Justo, S., Latorre, A., Lima, J., Lobo, J. L., Lopez-Jimenez, L., Lopez-Miguel, P., Lopez-Nunez, J. J., Lopez-Saez, J. B., Lorenzo, A., Madridano, O., Maestre, A., Marchena, P. J., Martin del Pozo, M., Martin-Martos, F., Martinez-Urbistondo, D., Mella, C., Mercado, M. I., Moises, J., Munoz, M., Munoz-Blanco, A., Nieto, J. A., Nofuentes-Perez, E., Nunez-Fernandez, M. J., Olid-Velilla, M., Olivares, M. C., Osorio, J., Otalora, S., Otero, R., Pedrajas, J. M., Pellejero, G., Porras, J. A., Portillo, J., Rodriguez-Matute, C., Rosa, V., Ruiz-Ruiz, J., Salgueiro, G., Sanchez-Martinez, R., Sanchez-Munoz-Torrero, J. F., Sancho, T., Soler, S., Suarez-Rodriguez, B., Surinach, J. M., Torres, M. I., Tolosa, C., Trujillo-Santos, J., Uresandi, F., Valle, R., Varona, J. F., Vela, L., Vela, J. R., Vidal, G., Villalobos, A., Villares, P., Zamora, C., Ay, C., Nopp, S., Pabinger, I., Vanassche, T., Vandenbriele, C., Hirmerova, J., Accassat, S., Ait Abdallah, N., Bura-Riviere, A., Catella, J., Couturaud, F., Crichi, B., Debourdeau, P., Espitia, O., Grange, C., Helfer, H., Lacut, K., Le Mao, R., Mahe, I., Morange, P., Moustafa, F., Poenou, G., Sarlon-Bartoli, G., Suchon, P., Quere, I., Braester, A., Basaglia, M., Bilora, F., Bortoluzzi, C., Brandolin, B., Ciammaichella, M., De Angelis, A., Imbalzano, E., Merla, S., Pesavento, R., Siniscalchi, C., Tufano, A., Visona, A., Vo Hong, N., Zalunardo, B., Nishimoto, Y., Sato, Y., Birzulis, J., Skride, A., Zaicenko, A., Fonseca, S., Martins, F., Meireles, J., Krstevski, G., and Mazzolai, L.

Subjects
Male, Registrie, Pulmonary and Respiratory Medicine, medicine.medical_specialty, pulmonary embolism, Critical Care and Intensive Care Medicine, Logistic regression, Heart Rate, Internal medicine, Heart rate, medicine, In patient, Aged, Aged, 80 and over, business.industry, medicine.disease, mortality, Pulmonary embolism, Prospective Studie, Increased risk, Spain, Cardiology, Positive relationship, Female, Cardiology and Cardiovascular Medicine, business, Human
Abstract

Background: The association between heart rate (HR) and pulmonary embolism (PE) outcomes has not been well studied. Furthermore, optimal cutoffs to identify low-risk and intermediate- to high-risk patients are not well known. Research Question: Does an association exist between baseline HR and PE outcome across the continuum of HR values? Study Design and Methods: The current study included 44,331 consecutive nonhypotensive patients with symptomatic PE from the Registro Informatizado de la Enfermedad TromboEmbólica registry between 2001 and 2021. Outcomes included 30-day all-cause and PE-specific mortality. We used hierarchical logistic regression to assess the association between admission HR and outcomes. Results: A positive relationship was found between admission HR and 30-day all-cause and PE-related mortality. Considering an HR of 80 to 99 beats/min as a reference, patients in the higher HR strata showed higher rates of all-cause death (adjusted OR, 1.5 for HR of 100-109 beats/min; adjusted OR, 1.7 for HR of 110-119 beats/min; adjusted OR, 1.9 for HR of 120-139 beats/min; and adjusted OR, 2.4 for HR of ≥ 140 beats/min). Patients in the lower strata of HR showed significantly lower rates of 30-day all-cause mortality compared with the same reference group (adjusted OR, 0.6 for HR of 60-79 beats/min; and adjusted OR, 0.5 for HR of < 60 beats/min). The findings for 30-day PE-related mortality were similar. For identification of low-risk patients, a cutoff value of 80 beats/min (vs 110 beats/min) increased the sensitivity of the simplified Pulmonary Embolism Severity Index (sPESI) from 93.4% to 98.8%. For identification of intermediate- to high-risk patients, a cutoff value of 140 beats/min (vs 110 beats/min) increased the specificity of the Bova score from 93.2% to 98.0%. Interpretation: In nonhypotensive patients with acute symptomatic PE, a high HR portends an increased risk of all-cause and PE-related mortality. Modifying the HR cutoff in the sPESI and the Bova score improves prognostication of patients with PE.

Published
2022

3. Association Between Preexisting Versus Newly Identified Atrial Fibrillation and Outcomes of Patients With Acute Pulmonary Embolism

Author

Behnood Bikdeli, David Jiménez, Jorge del Toro, Gregory Piazza, Agustina Rivas, José Luis Fernández‐Reyes, Ángel Sampériz, Remedios Otero, José María Suriñach, Carmine Siniscalchi, Javier Miguel Martín‐Guerra, Joaquín Castro, Alfonso Muriel, Gregory Y. H. Lip, Samuel Z. Goldhaber, Manuel Monreal, Paolo Prandoni, Benjamin Brenner, Dominique Farge‐Bancel, Raquel Barba, Pierpaolo Di Micco, Laurent Bertoletti, Sebastian Schellong, Inna Tzoran, Abilio Reis, Marijan Bosevski, Henri Bounameaux, Radovan Malý, Peter Verhamme, Joseph A. Caprini, Hanh My Bui, María Dolores Adarraga, María Agud, Jesús Aibar, Miguel Ángel Aibar, Cristina Amado, Juan Ignacio Arcelus, Carlos Baeza, Aitor Ballaz, Cristina Barbagelata, Manuel Barrón, Belén Barrón‐Andrés, Ángeles Blanco‐Molina, Ernesto Botella, Ana María Camon, Inmaculada Cañas, Ignacio Casado, Leyre Chasco, Juan Criado, Cristina de Ancos, Javier de Miguel, Pablo Demelo‐Rodríguez, José Antonio Díaz‐Peromingo, Mario Virgilio Di Campli, Javier Díez‐Sierra, Irene Milagros Domínguez, José Carlos Escribano, Conxita Falgá, Ana Isabel Farfán‐Sedano, Carmen Fernández‐Capitán, Jose Luis Fernández‐Reyes, María Ángeles Fidalgo, Katia Flores, Carme Font, Llorenç Font, Iria Francisco, Cristina Gabara, Francisco Galeano‐Valle, David Galindo, María Angelina García, Ferrán García‐Bragado, Marta García de Herreros, Raquel García‐Hernáez, María Mar García‐Mullor, Arantxa García‐Raso, Olga Gavín‐Sebastián, Aida Gil‐Díaz, Covadonga Gómez‐Cuervo, Enric Grau, Leticia Guirado, Javier Gutiérrez, Luis Hernández‐Blasco, Elena Hernando, Miguel Herreros, Luis Jara‐Palomares, María Jesús Jaras, Rafael Jiménez, Maria Dolores Joya, José Manuel León, Jorge Lima, Pilar Llamas, José Luis Lobo, Luciano López‐Jiménez, Patricia López‐Miguel, Juan José López‐Núñez, Raquel López‐Reyes, Antonio López‐Ruiz, Juan Bosco López‐Sáez, Alicia Lorenzo, Olga Madridano, Ana Maestre, Pablo Javier Marchena, Mar Martín del Pozo, Francisco Martín‐Martos, Carmen Mella, Meritxell Mellado, Maria Isabel Mercado, Jorge Moisés, María del Valle Morales, Arturo Muñoz‐Blanco, Nuria Muñoz‐Rivas, María Sierra Navas, Jose Antonio Nieto, Manuel Jesús Núñez‐Fernández, Berta Obispo, Mónica Olid, María Carmen Olivares, José Luis Orcastegui, Clara Ortega‐Michel, Jeisson Osorio, Sonia Otalora, Pedro Parra, Virginia Parra, José María Pedrajas, Galadriel Pellejero, José Antonio Porras, José Portillo, Antoni Riera‐Mestre, Francisco Rivera‐Civico, Diego Agustín Rodríguez‐Chiaradía, Ana Rodríguez‐Cobo, Consolación Rodríguez‐Matute, Jacobo Rogado, Sonia Roig, Vladimir Rosa, Pedro Ruiz‐Artacho, Nuria Ruiz‐Giménez, Justo Ruiz‐Ruiz, Pablo Ruiz‐Sada, Giorgina Salgueiro, Rosario Sánchez‐Martínez, Juan Francisco Sánchez‐Muñoz‐Torrero, Teresa Sancho, Merçe Sirisi, Silvia Soler, Raimundo Tirado, María Isabel Torres, Carles Tolosa, Javier Trujillo‐Santos, Fernando Uresandi, Beatriz Valero, Reina Valle, Jerónimo Ramón Vela, Gemma Vidal, Paula Villares, Carles Zamora, Paula Gutiérrez, Fernando Javier Vázquez, Matthias Engelen, Thomas Vanassche, Jana Hirmerova, Estuardo Salgado, Nassim Ait Abdallah, Alessandra Bura‐Riviere, Benjamin Crichi, Philippe Debourdeau, Espitia Olivier, Nicolas Falvo, Silvia Galliazzo, Hélène Helfer, Isabelle Mahé, Farès Moustafa, Geraldine Poenou, Andrei Braester, Franca Bilora, Eugenio Bucherini, Maurizio Ciammaichella, Egidio Imbalzano, Rosa Maida, Daniela Mastroiacovo, Federica Pace, Raffaele Pesavento, Fulvio Pomero, Roberto Quintavalla, Anna Rocci, Roberta Romualdi, Antonella Tufano, Adriana Visonà, Beniamino Zalunardo, Valdis Gibietis, Dana Kigitovica, Andris Skride, Samuel Fonseca, Filipa Martins, Jose Meireles, Lucia Mazzolai, Alfonso J. Tafur, Cassius Iyad Ochoa‐Chaar, Ido Weinberg, Hannah Wilkins, Institut Català de la Salut, [Bikdeli B] Cardiovascular Medicine Division, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA. Yale/YNHH Center for Outcomes Research & Evaluation, New Haven, CT. Cardiovascular Research Foundation (CRF), New York, NY. [Jiménez D] Respiratory Department, Hospital Ramón y Cajal (IRYCIS), Madrid, Spain. Medicine Department, Universidad de Alcalá (IRYCIS), Madrid, Spain. CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain. [Del Toro J] Department of Internal Medicine, Hospital General Universitario Gregorio Marañón, Madrid, Spain. [Piazza G] Cardiovascular Medicine Division, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA. [Rivas A] Department of Pneumonology, Hospital Universitario Araba, Álava, Spain. [Fernández-Reyes JL] Department of Internal Medicine, Complejo Hospitalario de Jaén, Jaén, Spain. [Suriñach JM] Servei de Medicina Interna, Vall d’Hebron Hospital Universitari, Barcelona, Spain, Vall d'Hebron Barcelona Hospital Campus, Bikdeli, B., Jimenez, D., Toro, J. D., Piazza, G., Rivas, A., Fernandez-Reyes, J. L., Samperiz, A., Otero, R., Surinach, J. M., Siniscalchi, C., Martin-Guerra, J. M., Castro, J., Muriel, A., Lip, G. Y. H., Goldhaber, S. Z., Monreal, M., and Tufano, A

Subjects
Registrie, medicine.medical_specialty, Embolism, enfermedades cardiovasculares::enfermedades cardíacas::arritmias cardíacas::fibrilación atrial [ENFERMEDADES], Otros calificadores::/diagnóstico [Otros calificadores], Vascular Medicine, Risk Factors, Internal medicine, Other subheadings::Other subheadings::Other subheadings::/mortality [Other subheadings], Atrial Fibrillation, medicine, Other subheadings::/diagnosis [Other subheadings], Diseases of the circulatory (Cardiovascular) system, Humans, Registries, Cor - Malalties - Diagnòstic, Mortality, Original Research, Outcome, Otros calificadores::Otros calificadores::Otros calificadores::/mortalidad [Otros calificadores], business.industry, Risk Factor, Pulmonary embolism, Thrombosis, Atrial fibrillation, medicine.disease, Cardiovascular Diseases::Vascular Diseases::Embolism and Thrombosis::Embolism::Pulmonary Embolism [DISEASES], Stroke, Embòlia pulmonar - Mortalitat, RC666-701, Acute Disease, Cardiology, Avaluació de resultats (Assistència sanitària), Cardiology and Cardiovascular Medicine, business, enfermedades cardiovasculares::enfermedades vasculares::embolia y trombosis::embolia::embolia pulmonar [ENFERMEDADES], Cardiovascular Diseases::Heart Diseases::Arrhythmias, Cardiac::Atrial Fibrillation [DISEASES], Human
Abstract

Background Atrial fibrillation (AF) may exist before or occur early in the course of pulmonary embolism (PE). We determined the PE outcomes based on the presence and timing of AF. Methods and Results Using the data from a multicenter PE registry, we identified 3 groups: (1) those with preexisting AF, (2) patients with new AF within 2 days from acute PE (incident AF), and (3) patients without AF. We assessed the 90‐day and 1‐year risk of mortality and stroke in patients with AF, compared with those without AF (reference group). Among 16 497 patients with PE, 792 had preexisting AF. These patients had increased odds of 90‐day all‐cause (odds ratio [OR], 2.81; 95% CI, 2.33–3.38) and PE‐related mortality (OR, 2.38; 95% CI, 1.37–4.14) and increased 1‐year hazard for ischemic stroke (hazard ratio, 5.48; 95% CI, 3.10–9.69) compared with those without AF. After multivariable adjustment, preexisting AF was associated with significantly increased odds of all‐cause mortality (OR, 1.91; 95% CI, 1.57–2.32) but not PE‐related mortality (OR, 1.50; 95% CI, 0.85–2.66). Among 16 497 patients with PE, 445 developed new incident AF within 2 days of acute PE. Incident AF was associated with increased odds of 90‐day all‐cause (OR, 2.28; 95% CI, 1.75–2.97) and PE‐related (OR, 3.64; 95% CI, 2.01–6.59) mortality but not stroke. Findings were similar in multivariable analyses. Conclusions In patients with acute symptomatic PE, both preexisting AF and incident AF predict adverse clinical outcomes. The type of adverse outcomes may differ depending on the timing of AF onset.

Published
2021

4. The Contribution of Digital Health in the Response to Covid-19 in Vietnam

Author

Long Viet Bui, Son Thai Ha, Ha Ngoc Nguyen, Truong Thanh Nguyen, Thuy Phuong Nguyen, Kien Tran, Tuyen Van Tran, Tu Huu Nguyen, Thong Huy Tran, Nghiem Duc Pham, and Hanh My Bui

Subjects
Economic growth, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), SARS-CoV-2, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Public health, Corporate governance, public health, digital health, Public Health, Environmental and Occupational Health, COVID-19, Digital health, Vietnam, Software deployment, Pandemic, Perspective, medicine, Risk communication, Humans, Business, Public aspects of medicine, RA1-1270, Pandemics, policy
Abstract

Emerging from early of 2020, the COVID-19 pandemic has become one of the most serious health crisis globally. In response to such threat, a wide range of digital health applications has been deployed in Vietnam to strengthen surveillance, risk communication, diagnosis, and treatment of COVID-19. Digital health has brought enormous benefits to the fight against COVID-19, however, numerous constrains in digital health application remain. Lack of strong governance of digital health development and deployment; insufficient infrastructure and staff capacity for digital health application are among the main drawbacks. Despite several outstanding problems, digital health is expected to contribute to reducing the spread, improving the effectiveness of pandemic control, and adding to the dramatic transformation of the health system the post-COVID era.

Published
2021
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5. Comparative clinical prognosis of massive and non-massive pulmonary embolism: A registry-based cohort study

Author

Marc Blondon, David Jimenez, Helia Robert‐Ebadi, Jorge Del Toro, Luciano Lopez‐Jimenez, Conxita Falga, Andris Skride, Llorenç Font, Fernando Javier Vazquez, Henri Bounameaux, Manuel Monreal, Paolo Prandoni, Benjamin Brenner, Dominique Farge‐Bancel, Raquel Barba, Pierpaolo Di Micco, Laurent Bertoletti, Sebastian Schellong, Inna Tzoran, Abilio Reis, Marijan Bosevski, Radovan Malý, Peter Verhamme, Joseph A Caprini, Hanh My Bui, MD Adarraga, M Agud, J Aibar, MA Aibar, J Alfonso, C Amado, JI Arcelus, C Baeza, A Ballaz, R Barba, C Barbagelata, M Barrón, B Barrón‐Andrés, A Blanco‐Molina, E Botella, AM Camon, J Castro, MA Caudevilla, P Cerdà, L Chasco, J Criado, C de Ancos, J de Miguel, P Demelo‐Rodríguez, JA Díaz‐Peromingo, J Díez‐Sierra, R Díaz‐Simón, IM Domínguez, M Encabo, JC Escribano, C Falgá, AI Farfán, C Fernández‐Capitán, JL Fernández‐Reyes, MA Fidalgo, K Flores, C Font, I Francisco, C Gabara, F Galeano‐Valle, MA García, F García‐Bragado, MM García‐Mullor, O Gavín‐Blanco, O Gavín‐Sebastián, A Gil‐Díaz, C Gómez‐Cuervo, J González‐Martínez, E Grau, L Guirado, J Gutiérrez, L Hernández‐Blasco, L Jara‐Palomares, MJ Jaras, D Jiménez, MD Joya, I Jou, B Lacruz, R Lecumberri, J Lima, JL Lobo, H López‐Brull, L López‐Jiménez, P López‐Miguel, JJ López‐Núñez, R López‐Reyes, JB López‐Sáez, MA Lorente, A Lorenzo, M Loring, O Madridano, A Maestre, PJ Marchena, M Martín del Pozo, F Martín‐Martos, C Martínez‐Baquerizo, C Mella, M Mellado, MI Mercado, J Moisés, MV Morales, A Muñoz‐Blanco, D Muñoz‐Guglielmetti, N Muñoz‐Rivas, E Nart, JA Nieto, MJ Núñez, MC Olivares, C Ortega‐Michel, MD Ortega‐Recio, J Osorio, S Otalora, R Otero, P Parra, V Parra, JM Pedrajas, G Pellejero, A Pérez‐Jacoiste, ML Peris, D Pesántez, JA Porras, J Portillo, L Reig, A Riera‐Mestre, A Rivas, A Rodríguez‐Cobo, C Rodríguez‐Matute, J Rogado, V Rosa, CM Rubio, P Ruiz‐Artacho, N Ruiz‐Giménez, J Ruiz‐Ruiz, P Ruiz‐Sada, JC Sahuquillo, G Salgueiro, A Sampériz, JF Sánchez‐Muñoz‐Torrero, T Sancho, P Sigüenza, M Sirisi, S Soler, S Suárez, JM Suriñach, G Tiberio, MI Torres, C Tolosa, J Trujillo‐Santos, F Uresandi, E Usandizaga, R Valle, JR Vela, G Vidal, C Vilar, P Villares, C Zamora, P Gutiérrez, FJ Vázquez, T Vanassche, C Vandenbriele, P Verhamme, J Hirmerova, R Malý, E Salgado, I Benzidia, L Bertoletti, A Bura‐Riviere, B Crichi, P Debourdeau, O Espitia, D Farge‐Bancel, H Helfer, I Mahé, F Moustafa, G Poenou, S Schellong, A Braester, B Brenner, I Tzoran, M Amitrano, F Bilora, C Bortoluzzi, B Brandolin, M Ciammaichella, D Colaizzo, F Dentali, P Di Micco, E Giammarino, E Grandone, S Mangiacapra, D Mastroiacovo, R Maida, N Mumoli, F Pace, R Pesavento, F Pomero, P Prandoni, R Quintavalla, A Rocci, C Siniscalchi, A Tufano, A Visonà, N Vo Hong, B Zalunardo, RV Kalejs, K Maķe, M Ferreira, S Fonseca, F Martins, J Meireles, M Bosevski, M Zdraveska, L Mazzolai, JA Caprini, AJ Tafur, I Weinberg, H Wilkins, HM Bui, Blondon, M., Jimenez, D., Robert-Ebadi, H., Del Toro, J., Lopez-Jimenez, L., Falga, C., Skride, A., Font, L., Vazquez, F. J., Bounameaux, H., Monreal, M., Prandoni, P., Brenner, B., Farge-Bancel, D., Barba, R., Di Micco, P., Bertoletti, L., Schellong, S., Tzoran, I., Reis, A., Bosevski, M., Maly, R., Verhamme, P., Caprini, J. A., My Bui, H., Adarraga, M. D., Agud, M., Aibar, J., Aibar, M. A., Alfonso, J., Amado, C., Arcelus, J. I., Baeza, C., Ballaz, A., Barbagelata, C., Barron, M., Barron-Andres, B., Blanco-Molina, A., Botella, E., Camon, A. M., Castro, J., Caudevilla, M. A., Cerda, P., Chasco, L., Criado, J., de Ancos, C., de Miguel, J., Demelo-Rodriguez, P., Diaz-Peromingo, J. A., Diez-Sierra, J., Diaz-Simon, R., Dominguez, I. M., Encabo, M., Escribano, J. C., Farfan, A. I., Fernandez-Capitan, C., Fernandez-Reyes, J. L., Fidalgo, M. A., Flores, K., Font, C., Francisco, I., Gabara, C., Galeano-Valle, F., Garcia, M. A., Garcia-Bragado, F., Garcia-Mullor, M. M., Gavin-Blanco, O., Gavin-Sebastian, O., Gil-Diaz, A., Gomez-Cuervo, C., Gonzalez-Martinez, J., Grau, E., Guirado, L., Gutierrez, J., Hernandez-Blasco, L., Jara-Palomares, L., Jaras, M. J., Joya, M. D., Jou, I., Lacruz, B., Lecumberri, R., Lima, J., Lobo, J. L., Lopez-Brull, H., Lopez-Miguel, P., Lopez-Nunez, J. J., Lopez-Reyes, R., Lopez-Saez, J. B., Lorente, M. A., Lorenzo, A., Loring, M., Madridano, O., Maestre, A., Marchena, P. J., Martin del Pozo, M., Martin-Martos, F., Martinez-Baquerizo, C., Mella, C., Mellado, M., Mercado, M. I., Moises, J., Morales, M. V., Munoz-Blanco, A., Munoz-Guglielmetti, D., Munoz-Rivas, N., Nart, E., Nieto, J. A., Nunez, M. J., Olivares, M. C., Ortega-Michel, C., Ortega-Recio, M. D., Osorio, J., Otalora, S., Otero, R., Parra, P., Parra, V., Pedrajas, J. M., Pellejero, G., Perez-Jacoiste, A., Peris, M. L., Pesantez, D., Porras, J. A., Portillo, J., Reig, L., Riera-Mestre, A., Rivas, A., Rodriguez-Cobo, A., Rodriguez-Matute, C., Rogado, J., Rosa, V., Rubio, C. M., Ruiz-Artacho, P., Ruiz-Gimenez, N., Ruiz-Ruiz, J., Ruiz-Sada, P., Sahuquillo, J. C., Salgueiro, G., Samperiz, A., Sanchez-Munoz-Torrero, J. F., Sancho, T., Siguenza, P., Sirisi, M., Soler, S., Suarez, S., Surinach, J. M., Tiberio, G., Torres, M. I., Tolosa, C., Trujillo-Santos, J., Uresandi, F., Usandizaga, E., Valle, R., Vela, J. R., Vidal, G., Vilar, C., Villares, P., Zamora, C., Gutierrez, P., Vanassche, T., Vandenbriele, C., Hirmerova, J., Salgado, E., Benzidia, I., Bura-Riviere, A., Crichi, B., Debourdeau, P., Espitia, O., Helfer, H., Mahe, I., Moustafa, F., Poenou, G., Braester, A., Amitrano, M., Bilora, F., Bortoluzzi, C., Brandolin, B., Ciammaichella, M., Colaizzo, D., Dentali, F., Giammarino, E., Grandone, E., Mangiacapra, S., Mastroiacovo, D., Maida, R., Mumoli, N., Pace, F., Pesavento, R., Pomero, F., Quintavalla, R., Rocci, A., Siniscalchi, C., Tufano, A., Visona, A., Vo Hong, N., Zalunardo, B., Kalejs, R. V., Maie, K., Ferreira, M., Fonseca, S., Martins, F., Meireles, J., Zdraveska, M., Mazzolai, L., Tafur, A. J., Weinberg, I., Wilkins, H., and Bui, H. M.

Subjects
Registrie, medicine.medical_specialty, pulmonary embolism, Prognosi, Hemodynamics, 030204 cardiovascular system & hematology, Cohort Studies, 03 medical and health sciences, Clinical prognosis, 0302 clinical medicine, Recurrence, Internal medicine, Case fatality rate, medicine, Humans, hemorrhage, mortality, prognosis, thrombolytic therapy, Registries, cardiovascular diseases, business.industry, Anticoagulant, Anticoagulants, Hematology, Venous Thromboembolism, Prognosis, medicine.disease, Confidence interval, Pulmonary embolism, Discontinuation, Cohort Studie, business, Venous thromboembolism, Cohort study, Human
Abstract

Aims Little is known about the prognosis of patients with massive pulmonary embolism (PE) and its risk of recurrent venous thromboembolism (VTE) compared with non-massive PE, which may inform clinical decisions. Our aim was to compare the risk of recurrent VTE, bleeding, and mortality after massive and non-massive PE during anticoagulation and after its discontinuation. Methods and results We included all participants in the RIETE registry who suffered a symptomatic, objectively confirmed segmental or more central PE. Massive PE was defined by a systolic hypotension at clinical presentation (

Published
2021

6. Prediction of early mortality in patients with cancer-associated thrombosis in the rIete Database

Author

Fuentes, Harry E., Tafur, Alfonso J., Caprini, Joseph A., Alatri, Adriano, Trujillo-santos, Javier, Farge-bancel, Dominique, Rosa, Vladimir, Font, Llorenc, Vilaseca, Alicia, Monreal, Manuel, Adarraga, Maria D., Aibar, Miguel A., Aibar, Jesus, Amado, Cristina, Aranda, Carlos, Arcelus Juan, I, Ballaz, Aitor, Barba, Raquel, Barillari, Giovanni, Barron, Manuel, Barron-Andres, Belen, Bascunana, Jose, Benzidia, Ilham, Bertoletti, Laurent, Blanco-Molina, Angeles, Bilora, Franca, Bortoluzzi, Cristiano, Bosevski, Marijan, Bounameaux, Henri, Braester, Andrei, Brandolin, Barbara, Brenner, Benjamin, Bucherini, Eugenio, Hanh My Bui, Bura-Riviere, Alessandra, Camon, Ana M., Carrasco, Cristina, Castro, Joaquin, Cesta, Alisia, Ciammaichella, Maurizio, Cruz, Javier A., de Ancos, Cristina, del Toro, Jorge, Demelo, Pablo, Dentali, Francesco, del Carmen Diaz-pedroche, Maria, Diaz-Peromingo, Jose A., Di Micco, Pierpaolo, Di Pangrazio, Marco, Ellis, Martin, Encabo, Marta, Falga, Conxita, Falvo, Nicolas, Farfan Ana, Fernandez-Capitan, Carmen, Angeles Fidalgo, Maria, Font, Carme, Fresa, Marco, Furest, Ildefonso, Garcia, Maria A., Garcia-Braoado, Ferran, Garcia-Morillo, Marcia, Garcia-Raso, Aranzazu, Gavin, Olga, Gil-Diaz, Aida, Gomez, Vicente, Gomez-Cuervo, Covadonga, Gonzalez-Martinez, Jose, Grandone, Elvira, Grau, Enric, Guijarro, Ricardo, Gutierrez, Javier, Gutierrez, Paula, Hernandez-Blasco, Luis, Hu, Adrian, Hirmerova, Jana, Imbalzano, Egidio, Jara-Palomares, Luis, Jaras, Maria J., Jimenez, David, Jou, Ines, Joya, Maria D., Krstevski, Gorjan, Lessiani, Gianfranco, Lima, Jorge, Llamas, Pilar, Lobo, Jose L., Lopez-Jimenez, Luciano, Lopez-Miguel, Patricia, Lopez-Nunez, Juan J., Lopez-Reyes, Raquel, Lopez-Saez, Juan B., Lorente, Manuel A., Lorenzo, Alicia, Loring, Monica, Lumbierres, Marina, Mahe, Isabelle, Maida, Rosa, Maly, Radovan, Manrique-Abos, Isabel, Marchena, Pablo J., Martin-Fernandez, Miguel, Martin-Guerra, Javier M., Martin-Romero, Miguel, Mastroiacovo, Danicla, Mazzolai, Lucia, Mellado, Meritxell, Merah, Adel, del Valle Morales, Maria, Moustafa, Fares, Ney, Barbara, Nieto, Jose A., Nunez, Manuel J., del Carmen Olivares, Maria, Otalora, Sonia, Otero, Remedios, Pace, Federica, Parisi, Roberto, Pedrajas, Jose Maria, Pellejero, Galadriel, Perez-Ductor, Cristina, Perez-Jacoiste, Asuncion, Perez-Rus, Gloria, Peris, Maria L., Pesavento, Raffaele, Pesce, Maria L., Porras, Jose A., Prandoni, Paolo, Quinta-Valla, Roberto, Riesco, David, Rivas, Agustina, Rocci, Anna, Rodriguez-Davila, Maria A., Rodriguez-Hernandez, Adela, Rubio, Carmen M., Ruiz-Alcaraz, Sandra, Ruiz-Artacho, Pedro, Ruiz-Ruiz, Justo, Ruiz-Sada, Pablo, Ruiz-Torregrosa, Paloma, Sahuquillo, Joan C., Sala-Sainz, Carmen, Salgado, Estuardo, Samperiz, Angel, Sanchez-Munoz-Torrero, Juan F., Sancho, Teresa, Sanoja, Indra D., Siniscalchi, Carmine, Skride, Andris, Soler, Silvia, Sotgiu, Pietro, Soto, Maria J., Surinach, Jose M., Tiraferri, Eros, Tonello, Diego, Torres Maria, Tufano, Antonella, Tzoran, Inns, Uresandi, Fernando, Usandizaga, Esther, Valle, Reins, Vanassche, Thomas, Vandenbriele, Christophe, Vazquez, Fernando J., Verhamme, Peter, Villalobos, Aurora, Visona, Adriana, Ngoc Vo Hong, Yoo, Hugo H., Zdraveska, Marija, Fuentes, Harry E., Tafur, Alfonso J., Caprini, Joseph A., Alatri, Adriano, Trujillo-santos, Javier, Farge-bancel, Dominique, Rosa, Vladimir, Font, Llorenc, Vilaseca, Alicia, Monreal, Manuel, Adarraga, Maria D., Aibar, Miguel A., Aibar, Jesu, Amado, Cristina, Aranda, Carlo, Arcelus, Juan, I, Ballaz, Aitor, Barba, Raquel, Barillari, Giovanni, Barron, Manuel, Barron-Andres, Belen, Bascunana, Jose, Benzidia, Ilham, Bertoletti, Laurent, Blanco-Molina, Angele, Bilora, Franca, Bortoluzzi, Cristiano, Bosevski, Marijan, Bounameaux, Henri, Braester, Andrei, Brandolin, Barbara, Brenner, Benjamin, Bucherini, Eugenio, Hanh My, Bui, Bura-Riviere, Alessandra, Camon, Ana M., Carrasco, Cristina, Castro, Joaquin, Cesta, Alisia, Ciammaichella, Maurizio, Cruz, Javier A., de Ancos, Cristina, del Toro, Jorge, Demelo, Pablo, Dentali, Francesco, del Carmen Diaz-pedroche, Maria, Diaz-Peromingo, Jose A., Di Micco, Pierpaolo, Di Pangrazio, Marco, Ellis, Martin, Encabo, Marta, Falga, Conxita, Falvo, Nicola, Farfan, Ana, Fernandez-Capitan, Carmen, Angeles Fidalgo, Maria, Font, Carme, Fresa, Marco, Furest, Ildefonso, Garcia, Maria A., Garcia-Braoado, Ferran, Garcia-Morillo, Marcia, Garcia-Raso, Aranzazu, Gavin, Olga, Gil-Diaz, Aida, Gomez, Vicente, Gomez-Cuervo, Covadonga, Gonzalez-Martinez, Jose, Grandone, Elvira, Grau, Enric, Guijarro, Ricardo, Gutierrez, Javier, Gutierrez, Paula, Hernandez-Blasco, Lui, Hu, Adrian, Hirmerova, Jana, Imbalzano, Egidio, Jara-Palomares, Lui, Jaras, Maria J., Jimenez, David, Jou, Ine, Joya, Maria D., Krstevski, Gorjan, Lessiani, Gianfranco, Lima, Jorge, Llamas, Pilar, Lobo, Jose L., Lopez-Jimenez, Luciano, Lopez-Miguel, Patricia, Lopez-Nunez, Juan J., Lopez-Reyes, Raquel, Lopez-Saez, Juan B., Lorente, Manuel A., Lorenzo, Alicia, Loring, Monica, Lumbierres, Marina, Mahe, Isabelle, Maida, Rosa, Maly, Radovan, Manrique-Abos, Isabel, Marchena, Pablo J., Martin-Fernandez, Miguel, Martin-Guerra, Javier M., Martin-Romero, Miguel, Mastroiacovo, Danicla, Mazzolai, Lucia, Mellado, Meritxell, Merah, Adel, del Valle Morales, Maria, Moustafa, Fare, Ney, Barbara, Nieto, Jose A., Nunez, Manuel J., del Carmen Olivares, Maria, Otalora, Sonia, Otero, Remedio, Pace, Federica, Parisi, Roberto, Pedrajas, Jose Maria, Pellejero, Galadriel, Perez-Ductor, Cristina, Perez-Jacoiste, Asuncion, Perez-Rus, Gloria, Peris, Maria L., Pesavento, Raffaele, Pesce, Maria L., Porras, Jose A., Prandoni, Paolo, Quinta-Valla, Roberto, Riesco, David, Rivas, Agustina, Rocci, Anna, Rodriguez-Davila, Maria A., Rodriguez-Hernandez, Adela, Rubio, Carmen M., Ruiz-Alcaraz, Sandra, Ruiz-Artacho, Pedro, Ruiz-Ruiz, Justo, Ruiz-Sada, Pablo, Ruiz-Torregrosa, Paloma, Sahuquillo, Joan C., Sala-Sainz, Carmen, Salgado, Estuardo, Samperiz, Angel, Sanchez-Munoz-Torrero, Juan F., Sancho, Teresa, Sanoja, Indra D., Siniscalchi, Carmine, Skride, Andri, Soler, Silvia, Sotgiu, Pietro, Soto, Maria J., Surinach, Jose M., Tiraferri, Ero, Tonello, Diego, Torres, Maria, Tufano, Antonella, Tzoran, Inn, Uresandi, Fernando, Usandizaga, Esther, Valle, Rein, Vanassche, Thoma, Vandenbriele, Christophe, Vazquez, Fernando J., Verhamme, Peter, Villalobos, Aurora, Visona, Adriana, Ngoc Vo, Hong, Yoo, Hugo H., and Zdraveska, Marija

Subjects
Adult, Male, Internationality, Adolescent, Population, 030204 cardiovascular system & hematology, 030230 surgery, computer.software_genre, Logistic regression, Risk Assessment, Cohort Studies, Young Adult, 03 medical and health sciences, Mortality, Neoplasms, Premature, Thrombosis, 0302 clinical medicine, Predictive Value of Tests, Risk Factors, Humans, Medicine, Registries, Child, education, Aged, education.field_of_study, Framingham Risk Score, Database, business.industry, Infant, Newborn, Infant, Venous Thromboembolism, Odds ratio, Middle Aged, medicine.disease, Pulmonary embolism, Logistic Models, Child, Preschool, Predictive value of tests, Multivariate Analysis, Female, Cardiology and Cardiovascular Medicine, Risk assessment, business, computer, Cohort study
Abstract

BACKGROUND: Proper risk stratification of patients for early mortality after cancer-associated thrombosis may lead to personalized anticoagulation protocols. Therefore, we aimed to derive and validate a scoring system to predict early mortality in this population. To this end, we selected patients with active cancer and thrombosis from the Computerized Registry of Patients with Venous Thromboembolism database. METHODS: The main outcome was all cause mortality within the month following a thrombotic event. We used a simple random selection to split are data in a derivation and a validation cohort. In the derivation cohort, we used recursive partitioning and binary logistic regression to identify groups at risk and to determine the likelihood of the primary outcome. The risk score was developed based on odds ratios from the final multivariate model, and then tested in the validation cohort. RESULTS: In 10,025 eligible patients, we identified 6 predictors of 30-day mortality: leukocytosis =11.5x109/L; platelet count =160x109/L, metastasis, recent immobility, initial presentation as pulmonary embolism and Body Mass Index

Published
2019

7. Patient-Level, Institutional, and Temporal Variations in Use of Imaging Modalities to Confirm Pulmonary Embolism

Author

Ghazaleh Mehdipoor, David Jimenez, Laurent Bertoletti, Ángeles Fidalgo, Juan Francisco Sanchez Muñoz-Torrero, José Pedro Gonzalez-Martinez, Ángeles Blanco-Molina, Miguel Ángel Aibar, Pierre-Benoît Bonnefoy, Ramin Khorasani, Martin R. Prince, Behnood Bikdeli, Manuel Monreal, María Dolores Adarraga, María Agud, Pedro Azcarate-Agüero, Jesús Aibar, Joaquín Alfonso, Cristina Amado, Juan Ignacio Arcelus, Aitor Ballaz, Raquel Barba, Cristina Barbagelata, Manuel Barrón, Belén Barrón-Andrés, Ana María Camon, Inmaculada Cañas, Juan Criado, Cristina de Ancos, Javier de Miguel, Jorge del Toro, Pablo Demelo-Rodríguez, Carmen Díaz-Pedroche, José Antonio Díaz-Peromingo, Raquel Díaz-Simón, Javier Díez-Sierra, Irene Milagros Domínguez, José Carlos Escribano, Ana Isabel Farfán, Carmen Fernández-Capitán, José Luis Fernández-Reyes, Katia Flores, Carme Font, Llorenç Font, Iria Francisco, Cristina Gabara, Francisco Galeano-Valle, María Ángeles García, Ferran García-Bragado, María García-García, Aránzazu García-Raso, Olga Gavín-Blanco, Olga Gavín-Sebastián, María Carmen Gayol, Aída Gil-Díaz, Covadonga Gómez-Cuervo, Enric Grau, Javier Gutiérrez-Guisado, Luis Hernández-Blasco, Marina Iglesias, Luis Jara-Palomares, María Jesús Jaras, María Dolores Joya, Inés Jou, Beatriz Lacruz, Antonio Lalueza, Ramón Lecumberri, Jorge Lima, Pilar Llamas, José Luis Lobo, Luciano López-Jiménez, Patricia López-Miguel, Juan José López-Núñez, Raquel López-Reyes, Juan Bosco López-Sáez, Manuel Alejandro Lorente, Alicia Lorenzo, Mónica Loring, Marina Lumbierres, Olga Madridano, Ana Maestre, Pablo Javier Marchena, Miguel Martín-Fernández, Javier Miguel Martín-Guerra, Francisco Martín-Martos, Meritxel Mellado, María Isabel Mercado, Jorge Moisés, María del Valle Morales, Arturo Muñoz-Blanco, Diego Muñoz-Guglielmetti, José Antonio Nieto, Manuel Jesús Núñez, María Carmen Olivares, Clara Ortega-Michel, María Dolores Ortega-Recio, Jeisson Osorio, Remedios Otero, Diana Paredes, Pedro Parra, Virginia Parra, José María Pedrajas, Galadriel Pellejero, Cristina Pérez-Ductor, María Asunción Pérez-Jacoíste, David Pesántez, José Antonio Porras, José Portillo, Lluis Reig, Antoni Riera-Mestre, Agustina Rivas, Ana Rodríguez-Cobo, Irene Rodríguez-Galán, Consolación Rodríguez-Matute, Vladimir Rosa, Carmen María Rubio, Pedro Ruiz-Artacho, Nuria Ruiz-Giménez, Justo Ruiz-Ruiz, Pablo Ruiz-Sada, Paloma Ruiz-Torregrosa, Joan Carles Sahuquillo, Giorgina Salgueiro, Ángel Sampériz, Teresa Sancho, Silvia Soler, Susana Suárez, José María Suriñach, Gregorio Tiberio, María Isabel Torres, Carlos Tolosa, Javier Trujillo-Santos, Fernando Uresandi, Esther Usandizaga, Reina Valle, Jeronimo Ramón Vela, Gemma Vidal, Paula Villares, Carles Zamora, Paula Gutiérrez, Fernando Javier Vázquez, Thomas Vanassche, Christophe Vandenbriele, Peter Verhamme, Jana Hirmerova, Radovan Malý, Estuardo Salgado, Ilham Benzidia, Alessandra Bura-Riviere, Benjamin Crichi, Philippe Debourdeau, Dominique Farge-Bancel, Hélène Helfer, Isabelle Mahé, Farès Moustafa, Geraldine Poenou, Sebastian Schellong, Andrei Braester, Benjamin Brenner, Inna Tzoran, María Amitrano, Franca Bilora, Cristiano Bortoluzzi, Barbara Brandolin, Eugenio Bucherini, Maurizio Ciammaichella, Donatella Colaizzo, Francesco Dentali, Pierpaolo Di Micco, Eliana Giammarino, Elvira Grandone, Fabio Maggi, Sara Mangiacapra, Daniela Mastroiacovo, Rosa Maida, Federica Pace, Raffaele Pesavento, Fulvio Pomero, Paolo Prandoni, Roberto Quintavalla, Anna Rocci, Carmine Siniscalchi, Eros Tiraferri, Antonella Tufano, Adriana Visonà, Ngoc Vo Hong, Beniamino Zalunardo, Roberts V. Kalejs, Dana Kigitovica, Andris Skride, Melanie Ferreira, Jose Meireles, Abilio Reis, Marijan Bosevski, Gorjan Krstevski, Marija Zdraveska, Henri Bounameaux, Lucia Mazzolai, Joseph A. Caprini, Alfonso J. Tafur, Ido Weinberg, Hannah Wilkins, and Hanh My Bui

Subjects
Diagnostic Imaging, Male, medicine.medical_specialty, pulmonary embolism, Hospitals, Low-Volume, Time Factors, Computed Tomography Angiography, Health Status, Perfusion Imaging, Comorbidity, Imaging modalities, Predictive Value of Tests, Pregnancy, medicine, Humans, Radiology, Nuclear Medicine and imaging, angiography, Prospective Studies, Registries, Healthcare Disparities, Practice Patterns, Physicians', thrombosis, Computed tomography angiography, Aged, Ultrasonography, Aged, 80 and over, Venous Thrombosis, Modality (human–computer interaction), medicine.diagnostic_test, business.industry, Ventilation/perfusion scan, Phlebography, Venous Thromboembolism, Middle Aged, medicine.disease, Thrombosis, Pulmonary embolism, Hospitalization, ventilation-perfusion scan, Angiography, Female, Radiology, Cardiology and Cardiovascular Medicine, business, Pulmonary Embolism, Hospitals, High-Volume, Magnetic Resonance Angiography
Abstract

Background: The choice of the imaging modality for diagnosis of pulmonary embolism (PE) could be influenced by provider, patient or hospital characteristics, or over time. However, little is known about the choice of the diagnostic modalities in practice. The aim of this study was to evaluate the variations in the use of imaging modalities for patients with acute PE. Methods: Using the data from Registro Informatizado Enfermedad TromboEmbolica (RIETE), a prospective international registry of patients with venous thromboembolism (March 2001–January 2019), we explored the imaging modalities used in patients with acute PE. The imaging modalities included computed tomography pulmonary angiography, ventilation/perfusion scanning, pulmonary angiography, a combination of these tests, or PE signs and symptoms plus imaging-confirmed proximal deep vein thrombosis but no chest imaging. Results: Among 38 025 patients with confirmed PE (53.1% female, age: 67.3±17 years), computed tomography pulmonary angiography was the dominant modality of diagnosis in all RIETE enrollees (78.2% [99% CI, 77.6–78.7]); including pregnant patients (58.9% [99% CI, 47.7%–69.4%]) and patients with severe renal insufficiency (62.5% [99% CI, 59.9–65.0]). A greater proportion of patients underwent ventilation/perfusion scanning in larger hospitals compared with smaller hospitals (13.1% versus 7.3%, P P Conclusions: In a large multinational PE registry, variations were observed in the use of imaging modalities according to patient or institutional factors and over time. However, computed tomography pulmonary angiography was the dominant modality of diagnosis, even in pregnancy and severe renal insufficiency. The safety, costs, and downstream effects of these tests on PE-related and non-PE-related outcomes warrant further investigation.

Published
2020

8. Incidence of major adverse cardiovascular events among patients with provoked and unprovoked venous thromboembolism: Findings from the Registro Informatizado de Enfermedad Tromboembólica Registry

Author

Fernando J. Vazquez, Hanh My Bui, R. Maida, Alicia Lorenzo, Iva Golemi, Remedios Otero, R. Otero, G. Pellejero, Pilar Llamas, M.J. Soto, J. del Toro, Inna Tzoran, K. Sablinskis, Carmine Siniscalchi, E. Bucherini, G. Vidal, Juan J. López-Núñez, N. Mumoli, J.M. Suriñach, S. Ruiz-Alcaraz, H. Bounameaux, Jose Gutierrez, E. Salgado, C. Carrasco, I. Gaya, R. Parisi, M.D. Adarraga, Peter Verhamme, Meritxell Mellado, N. Vo Hong, I. Jou, M.C. Gayol, M. García-Morillo, Marco Fresa, Luis Jara-Palomares, Daniela Mastroiacovo, M. Sablinskis, A. Rodríguez-Hernández, R. Díaz-Simón, Miguel Ángel Aibar, David Jiménez, Ángel Sampériz, Raquel López-Reyes, Isabelle Mahé, P. Ruiz-Sada, Martin Ellis, J.A. Porras, Omer Iftikhar, Ángeles Blanco-Molina, J. Aibar, R. Malý, M. Pérez-Pinar, Adriana Visonà, L. Guirado, Carme Font, M. Encabo, M.A. Lorente, María del Carmen Díaz-Pedroche, F. García-Bragado, Gianfranco Lessiani, P. Prandoni, T. Sancho, I. Sanoja, A. Tafur, Manuel Monreal, M.J. Jaras, Alessandra Bura-Rivière, Javier Trujillo-Santos, E. Grau, J. Castro, E. Imbalzano, P. Demelo, A.M. Camon, P. López-Miguel, R. Quintavalla, Alfonso Tafur, Laurent Bertoletti, N. Falvo, J. Ruiz-Ruiz, M. Pinelli, M.A. Fidalgo, Pablo Javier Marchena, Anna Rocci, Aitor Ballaz, José González-Martínez, Andrei Braester, J.F. Sánchez-Muñoz-Torrero, J. Bascuñana, Philippe Debourdeau, J.M. Pedrajas, Giovanni Barillari, C. Vandenbriele, H.M. Bui, M. Iglesias, M. Bosevski, Raffaele Pesavento, Barry M. Brenner, Antonella Tufano, Silvia Soler, F. Pace, Paolo Prandoni, L. Font, L. Bertoletti, A. García-Raso, G. Pérez-Rus, V. Salazar, Juan I. Arcelus, Barbara Ney, Lauren Cote, Raquel Barba, B. Brandolin, Luciano López-Jiménez, Pierpaolo Di Micco, C. Fernández-Capitán, M. Martín Fernández, M.A. García, R. Barba, R. Valle, Carmen Fernández-Capitán, M.L. Pesce, J.M. Martín-Guerra, D. Farge-Bancel, Conxita Falga, M. Lumbierres, Fernando Uresandi, Benjamin Brenner, Elvira Grandone, Mónica Loring, Dominique Farge-Bancel, A. Lalueza, Cristiano Bortoluzzi, M.J. Núñez, M.C. Olivares, Maurizio Ciammaichella, M.D. Joya, Agustina Rivas, Joan Carles Sahuquillo, C.M. Rubio, Abílio Reis, A. Vilaseca, P. Di Micco, Jana Hirmerova, M. Monreal, José María Pedrajas, M.L. Peris, M.A. Rodríguez-Dávila, S. Otalora, F. Bilora, E. Usandizaga, C. Amado, Pedro Ruiz-Artacho, Roberto Quintavalla, B. Barrón-Andrés, P.M. Azcarate, I. Benzidia, Lucia Mazzolai, P. Gutiérrez, Jorge Lima, O. Gavín, Thomas Vanassche, Farès Moustafa, V. Gómez, Andris Skride, Joseph A. Caprini, A. Gil-Díaz, Behnood Bikdeli, A. Hij, L. Rodríguez-Fernández, Olga Madridano, C. Rodríguez-Martín, C. de Ancos, Ana Maestre, M.C. Fernández-Criado, Henri Bounameaux, M.I. Torres, Radovan Malý, A.I. Farfán, I. Tzoran, J.A. Díaz-Peromingo, J.B. López-Sáez, M. Barrón, C. Tolosa, José Luis Lobo, Francesco Dentali, M. Zdraveska, Marijan Bosevski, L.M. Hernández Blasco, J.A. Nieto, Ma Morales, J. Caprini, Golemi, I., Cote, L., Iftikhar, O., Brenner, B., Tafur, A., Bikdeli, B., Fernandez-Capitan, C., Pedrajas, J. M., Otero, R., Quintavalla, R., Monreal, M., Prandoni, P., Farge-Bancel, D., Barba, R., Di Micco, P., Bertoletti, L., Tzoran, I., Reis, A., Bounameaux, H., Maly, R., Verhamme, P., Bosevski, M., Caprini, J. A., Bui, H. M., Adarraga, M. D., Aibar, M. A., Aibar, J., Amado, C., Arcelus, J. I., Azcarate, P. M., Ballaz, A., Barron, M., Barron-Andres, B., Bascunana, J., Blanco-Molina, A., Camon, A. M., Carrasco, C., Castro, J., de Ancos, C., del Toro, J., Demelo, P., Diaz-Pedroche, M. C., Diaz-Peromingo, J. A., Diaz-Simon, R., Encabo, M., Falga, C., Farfan, A. I., Fernandez-Criado, M. C., Fidalgo, M. A., Font, C., Font, L., Garcia, M. A., Garcia-Bragado, F., Garcia-Morillo, M., Garcia-Raso, A., Gavin, O., Gaya, I., Gayol, M. C., Gil-Diaz, A., Guirado, L., Gomez, V., Gonzalez-Martinez, J., Grau, E., Gutierrez, J., Hernandez Blasco, L. M., Iglesias, M., Jara-Palomares, L., Jaras, M. J., Jimenez, D., Jou, I., Joya, M. D., Lalueza, A., Lima, J., Llamas, P., Lobo, J. L., Lopez-Jimenez, L., Lopez-Miguel, P., Lopez-Nunez, J. J., Lopez-Reyes, R., Lopez-Saez, J. B., Lorente, M. A., Lorenzo, A., Loring, M., Lumbierres, M., Madridano, O., Maestre, A., Marchena, P. J., Martin-Guerra, J. M., Martin Fernandez, M., Mellado, M., Morales, M. V., Nieto, J. A., Nunez, M. J., Olivares, M. C., Otalora, S., Pellejero, G., Perez-Pinar, M., Perez-Rus, G., Peris, M. L., Pesce, M. L., Porras, J. A., Rivas, A., Rodriguez-Davila, M. A., Rodriguez-Fernandez, L., Rodriguez-Hernandez, A., Rodriguez-Martin, C., Rubio, C. M., Ruiz-Alcaraz, S., Ruiz-Artacho, P., Ruiz-Ruiz, J., Ruiz-Sada, P., Sahuquillo, J. C., Salazar, V., Samperiz, A., Sanchez-Munoz-Torrero, J. F., Sancho, T., Sanoja, I., Soler, S., Soto, M. J., Surinach, J. M., Tolosa, C., Torres, M. I., Trujillo-Santos, J., Uresandi, F., Usandizaga, E., Valle, R., Vidal, G., Gutierrez, P., Vazquez, F. J., Vilaseca, A., Vanassche, T., Vandenbriele, C., Hirmerova, J., Salgado, E., Benzidia, I., Bura-Riviere, A., Debourdeau, P., Falvo, N., Hij, A., Mahe, I., Moustafa, F., Braester, A., Ellis, M., Barillari, G., Bilora, F., Bortoluzzi, C., Brandolin, B., Bucherini, E., Ciammaichella, M., Dentali, F., Grandone, E., Imbalzano, E., Lessiani, G., Maida, R., Mastroiacovo, D., Mumoli, N., Vo Hong, N., Pace, F., Parisi, R., Pesavento, R., Pinelli, M., Rocci, A., Siniscalchi, C., Tufano, A., Visona, A., Skride, A., Sablinskis, K., Sablinskis, M., Zdraveska, M., Fresa, M., Ney, B., Mazzolai, L., and Caprini, J.

Subjects
Registrie, Male, Time Factors, Databases, Factual, Major adverse cardiovascular event, 030204 cardiovascular system & hematology, Coronary artery disease, 0302 clinical medicine, Retrospective Studie, Cardiovascular Disease, Major adverse limb events, Medicine, Registries, 030212 general & internal medicine, Myocardial infarction, Stroke, Incidence, Incidence (epidemiology), Hazard ratio, Major adverse limb event, Heart Disease Risk Factor, Middle Aged, Prognosis, Cardiovascular Diseases, Major adverse cardiovascular events, Female, VTE, Cardiology and Cardiovascular Medicine, Human, Provoked, Venous thromboembolism, medicine.medical_specialty, Time Factor, Prognosi, Risk Assessment, 03 medical and health sciences, Internal medicine, Humans, cardiovascular diseases, Aged, Retrospective Studies, business.industry, Unstable angina, medicine.disease, equipment and supplies, Confidence interval, Heart Disease Risk Factors, Surgery, business, Mace
Abstract

Registro Informatizado de Enfermedad Tromboembólica Investigators., [Objective] Overlap exists between the risk factors for coronary artery disease and venous thromboembolism (VTE). However, a paucity of data is available on the incidence of major acute cardiovascular events (MACE) and major adverse limb events (MALE) among patients presenting with VTE. Moreover, it is unknown whether the rate of cardiovascular outcomes differs among patients with unprovoked vs provoked VTE., [Methods] We analyzed the data from 2009 to 2017 in the Registro Informatizado de Enfermedad Tromboembólica registry, an ongoing, multicenter, international registry of consecutive patients with a diagnosis of objectively confirmed VTE. The query was restricted it to patients with data entry for the arterial outcomes. The baseline prevalence of coronary artery disease risk factors was compared between patients with provoked (ie, immobility, cancer, surgery, travel >6 hours, hormonal causes) and unprovoked VTE. After the initial VTE event, we followed up patients for the composite primary outcome of incident MACE (ie, stroke, myocardial infarction, unstable angina) and/or MALE (ie, major limb events). We used the χ2 test for baseline associations and a Cox proportional hazard for multivariate analysis. We used IBM SPSS, version 24 (IBM Corp, Armonk, NY) for statistical analysis. A P value of, [Results] We analyzed the data from 41,259 patients with VTE, of whom 22,633 (55.6%) had experienced a provoked VTE. During follow-up, the patients with provoked VTE were more likely to develop MACE or MALE than were patients with unprovoked VTE (hazard ratio [HR], 1.3; 95% confidence interval [CI], 1.1-1.5). The association of arterial events with recent immobility (HR, 1.4; 95% CI, 1.5-12.1) and cancer (HR, 1.7; 95% CI, 1.4-1.9) was strong. After adjusting for multiple conventional cardiovascular risk factors, provoked VTE, compared with unprovoked VTE, was significantly associated with an increased hazard for MACE (HR, 1.4; 95% CI, 1.1-1.7). Cancer remained a significant adjusted predictor for both MACE (HR, 1.7; 95% CI, 1.4-2.1) and MALE (HR, 2.1; 95% CI 1.01-4.6) in those with provoked VTE., [Conclusions] Among patients with VTE, provoked cases, specifically those with cancer-associated VTE, have an increased risk of major arterial events.

Published
2020

9. Comparison of seven prognostic tools to identify low-risk pulmonary embolism in patients aged <50 years

Author

Jara-Palomares, Luis, Alfonso, Maria, Maestre, Ana, Jimenez, David, Garcia-Bragado, Fernando, Font, Carme, Lopez Reyes, Raquel, Hernandez Blasco, Luis, Vidal, Gemma, Otero, Remedios, Monreal, Manuel, Adarraga, Ma Dolores, Angel Aibar, Miguel, Aibar, Jesus, Amado, Cristina, Ignacio Arcelus, Juan, Ballaz, Aitor, Barba, Raquel, Barron, Manuel, Barron-Andres, Belen, Bascunana, Jose, Blanco-Molina, Angeles, Maria Camon, Ana, Canas, Inmaculada, Carrasco, Cristina, Castro, Joaquin, de Ancos, Cristina, Del Toro, Jorge, Demelo, Pablo, Antonio Diaz-Peromingo, Jose, Diaz-Simon, Raquel, Falga, Conxita, Isabel Farfan, Ana, Fernandez-Capitan, Carmen, Del Carmen Fernandez-Criado, Maria, Fernandez-Nunez, Sandra, Fidalgo, Angeles, Font, Llorenc, Angelina Garcia, Maria, Garcia-Morillo, Marcial, Garcia-Raso, Aranzzu, Gavin-Sebastian, Olga, del Carmen Gayol, Maria, Gil-Diaz, Aida, Gomez, Vicente, Gomez-Cuervo, Covadonga, Gonzalez-Martinez, Jose, Grau, Enric, Gutierrez, Javier, Gutierrez-Gonzalez, Sara, Iglesias, Marina, Jaras, Ma Jesus, Jou, Ines, Dolores Joya, Maria, Lalueza, Antonio, Lima, Jorge, Llamas, Pilar, Luis Lobo, Jose, Lopez-Jimenez, Luciano, Lopez-Miguel, Patricia, Jose Lopez-Nunez, Juan, Bosco Lopez-Saez, Juan, Alejandro Lorente, Manuel, Lorenzo, Alicia, Loring, Monica, Madridano, Olga, Javier Marchena, Pablo, Miguel Martin, Javier, Mellado, Meritxell, del Valle Morales, Ma, Luisa Nieto, Maria, Antonio Nieto, Jose, Jesus Nunez, Manuel, Carmen Olivares, Maria, Maria Pedrajas, Jose, Pellejero, Galadriel, Prez-Rus, Gloria, Peris, Ma Luisa, Antonio Porras, Jose, Rivas, Agustina, Angeles Rodriguez-Davila, Ma, Adela Rodriguez-Hernandez, A, Rubio, Carmen Ma, Ruiz-Artacho, Pedro, Ruiz-Ruiz, Justo, Ruiz-Sada, Pablo, Carles Sahuquillo, Joan, Salazar, Vladimir, Samperiz, Angel, Sanchez Munoz-Torrero, Juan Francisco, Sancho, Teresa, Soler, Silvia, Maria Surinach, Jose, Tapia, Elena, Tolosa, Caries, Isabel Torres, Maria, Trujillo-Santos, Javier, Uresandi, Fernando, Valle, Reina, Villares, Paula, Gutierrez, Paula, Javier Vazquez, Fernando, Vilaseca, Alicia, Vanassche, Thomas, Vandenbriele, Christophe, Verhamme, Peter, Hirmerova, Jana, Maly, Radovan, Celis, Gregory, del Pozo, Gustavo, Salgado, Estuardo, Benzidia, Ilham, Bertoletti, Laurent, Bura-Riviere, Alessandra, Debourdeau, Philippe, Farge-Bancel, Dominique, Hij, Adrian, Mahe, Isabelle, Moustafa, Fares, Schellong, Sebastian, Braester, Andrei, Brenner, Benjamin, Tzoran, Inna, Sharif-Kashani, Babak, Barillari, Giovanni, Bilora, Franca, Bortoluzzi, Cristiano, Brandolin, Barbara, Bucherini, Eugenio, Ciammaichella, Maurizio, Dentali, Francesco, Di Micco, Pierpaolo, Maida, Rosa, Mastroiacovo, Daniela, Mumoli, Nicola, Pace, Federica, Parisi, Roberto, Pesavento, Raffaelle, Prandoni, Paolo, Quintavalla, Roberto, Rocci, Anna, Romualdi, Roberta, Sinicalchi, Carmine, Tufano, Antonella, Visona, Adriana, Hong, Ngoc Vo, Zalunardo, Beniamino, Gibietis, Valdis, Kigitovica, Dana, Skride, Andris, Bosevski, Marijan, Bounameaux, Henri, Mazzolai, Lucia, Caprini, Joseph A, Hanh, My Bui, Khanh, Quoc Pham, Reis, Abilio, UCH. Departamento de Medicina (Extinguido), Producción Científica UCH 2019, UCH. Departamento de Medicina y Cirugía, Sanofi España, Bayer, Sociedad Española de Neumología y Cirugía Torácica, Jara-Palomares, L., Alfonso, M., Maestre, A., Jimenez, D., Garcia-Bragado, F., Font, C., Reyes, R. L., Blasco, L. H., Vidal, G., Otero, R., Monreal, M., Adarraga, M. ªD., Aibar, M. A., Aibar, J., Amado, C., Arcelus, J. I., Ballaz, A., Barba, R., Barron, M., Barron-Andres, B., Bascunana, J., Blanco-Molina, A., Camon, A. M., Canas, I., Carrasco, C., Castro, J., de Ancos, C., Del Toro, J., Demelo, P., Diaz-Peromingo, J. A., Diaz-Simon, R., Falga, C., Farfan, A. I., Fernandez-Capitan, C., del Carmen Fernandez-Criado, M., Fernandez-Nunez, S., Fidalgo, A., Font, L., Garcia, M. A., Garcia-Morillo, M., Garcia-Raso, A., Gavin-Sebastian, O., del Carmen Gayol, M., Gil-Diaz, A., Gomez, V., Gomez-Cuervo, C., Gonzalez-Martinez, J., Grau, E., Gutierrez, J., Gutierrez-Gonzalez, S., Iglesias, M., Jaras, M. ªJ., Jou, I., Joya, M. D., Lalueza, A., Lima, J., Llamas, P., Lobo, J. L., Lopez-Jimenez, L., Lopez-Miguel, P., Lopez-Nunez, J. J., Lopez-Saez, J. B., Lorente, M. A., Lorenzo, A., Loring, M., Madridano, O., Marchena, P. J., Martin, J. M., Mellado, M., Morales, M. ªV., Nieto, M. L., Nieto, J. A., Nunez, M. J., Olivares, M. C., Pedrajas, J. M., Pellejero, G., Perez-Rus, G., Peris, M. ªL., Porras, J. A., Rivas, A., Rodriguez-Davila, M. ªA., Adela Rodriguez-Hernandez, A., Rubio, C. M., Ruiz-Artacho, P., Ruiz-Ruiz, J., Ruiz-Sada, P., Sahuquillo, J. C., Salazar, V., Samperiz, A., Munoz-Torrero, J. F. S., Sancho, T., Soler, S., Surinach, J. M., Tapia, E., Tolosa, C., Torres, M. I., Trujillo-Santos, J., Uresandi, F., Valle, R., Villares, P., Gutierrez, P., Vazquez, F. J., Vilaseca, A., Vanassche, T., Vandenbriele, C., Verhamme, P., Hirmerova, J., Maly, R., Celis, G., del Pozo, G., Salgado, E., Benzidia, I., Bertoletti, L., Bura-Riviere, A., Debourdeau, P., Farge-Bancel, D., Hij, A., Mahe, I., Moustafa, F., Schellong, S., Braester, A., Brenner, B., Tzoran, I., Sharif-Kashani, B., Barillari, G., Bilora, F., Bortoluzzi, C., Brandolin, B., Bucherini, E., Ciammaichella, M., Dentali, F., Di Micco, P., Maida, R., Mastroiacovo, D., Mumoli, N., Pace, F., Parisi, R., Pesavento, R., Prandoni, P., Quintavalla, R., Rocci, A., Romualdi, R., Sinicalchi, C., Tufano, A., Visona, A., Hong, N. V., Zalunardo, B., Gibietis, V., Kigitovica, D., Skride, A., Bosevski, M., Bounameaux, H., Mazzolai, L., Caprini, J. A., Bui, H. M., Pham, K. Q., and Reis, A.

Subjects
PREDICTION, Embolism, Aparato circulatorio - Enfermedades - Pronóstico, Cardiovascular system - Diseases - Prognosis, lcsh:Medicine, 030204 cardiovascular system & hematology, 0302 clinical medicine, Retrospective Studie, Risk Factors, 030212 general & internal medicine, lcsh:Science, INDEX, education.field_of_study, Multidisciplinary, Middle Aged, Prognosis, Predictive value, Pulmonary embolism, Multidisciplinary Sciences, DERIVATION, Science & Technology - Other Topics, Major bleeding, Human, medicine.medical_specialty, ANTITHROMBOTIC THERAPY, Disease-free survival, Prognosi, Population, DIAGNOSIS, VALIDATION, Article, 03 medical and health sciences, STRATIFICATION, Thromboembolism, Internal medicine, medicine, Humans, In patient, education, Retrospective Studies, OLDER, VENOUS THROMBOEMBOLISM, Science & Technology, business.industry, Risk Factor, lcsh:R, CLINICAL PRESENTATION, Retrospective cohort study, medicine.disease, Embolia pulmonar - Pronóstico, Shock index, Pulmonary embolism - Prognosis, Spain, lcsh:Q, business, Pulmonary Embolism
Abstract

The RIETE investigators., In young patients with acute pulmonary embolism (PE), the predictive value of currently available prognostic tools has not been evaluated. Our objective was to compare prognostic value of 7 available tools (GPS, PESI, sPESI, Prognostic Algorithm, PREP, shock index and RIETE) in patients aged, This study received funding: SEPAR (1/2016) grupo GeCIR. We express our gratitude to Sanofi Spain for supporting this Registry with an unrestricted educational grant. We also wish to thank Bayer Pharma AG for supporting this Registry. Bayer Pharma AG’s support was limited to the part of RIETE outside Spain, which accounts for a 25.20% of the total patients included in the RIETE Registry.

Published
2019

10. Timing and characteristics of venous thromboembolism after noncancer surgery

Author

Manuela Expósito-Ruiz, Juan Ignacio Arcelus, Joseph A. Caprini, Cristina López-Espada, Alessandra Bura-Riviere, Cristina Amado, Mónica Loring, Daniela Mastroiacovo, Manuel Monreal, Paolo Prandoni, Benjamin Brenner, Dominique Farge-Bancel, Raquel Barba, Pierpaolo Di Micco, Laurent Bertoletti, Sebastian Schellong, Inna Tzoran, Abilio Reis, Marijan Bosevski, Henri Bounameaux, Radovan Malý, Peter Verhamme, Hanh My Bui, M.D. Adarraga, M. Agud, J. Aibar, M.A. Aibar, C. Amado, J.I. Arcelus, C. Baeza, A. Ballaz, R. Barba, C. Barbagelata, M. Barrón, B. Barrón-Andrés, A. Blanco-Molina, E. Botella, A.M. Camon, S. Campos, I. Cañas, I. Casado, J. Castro, J. Criado, C. de Ancos, J. de Miguel, J. del Toro, P. Demelo-Rodríguez, C. Díaz-Pedroche, J.A. Díaz-Peromingo, J. Díez-Sierra, I.M. Domínguez, J.C. Escribano, C. Falgá, A.I. Farfán, K. Fernández de Roitegui, C. Fernández-Aracil, C. Fernández-Capitán, J.L. Fernández-Reyes, M.A. Fidalgo, K. Flores, C. Font, L. Font, I. Francisco, I. Furest, C. Gabara, F. Galeano-Valle, M.A. García, F. García-Bragado, R. García-Hernáez, A. García-Raso, O. Gavín-Sebastián, A. Gil-Díaz, C. Gómez-Cuervo, J. González-Martínez, E. Grau, M. Giménez-Suau, L. Guirado, J. Gutiérrez, L. Hernández-Blasco, E. Hernando, M. Herreros, L. Jara-Palomares, M.J. Jaras, D. Jiménez, R. Jiménez, M.D. Joya, I. Jou, A. Lalueza, R. Lecumberri, J. Lima, P. Llamas, J.L. Lobo, L. López-Jiménez, P. López-Miguel, J.J. López-Núñez, R. López-Reyes, J.B. López-Sáez, A. Lorenzo, M. Loring, O. Madridano, A. Maestre, P.J. Marchena, M. Martín del Pozo, F. Martín-Martos, C. Mella, M. Mellado, M.I. Mercado, J. Moisés, M. Monreal, M.V. Morales, A. Muñoz-Blanco, D. Muñoz-Guglielmetti, N. Muñoz-Rivas, J.A. Nieto, A. Núñez-Ares, M.J. Núñez-Fernández, B. Obispo, M.C. Olivares, J.L. Orcastegui, M.D. Ortega-Recio, J. Osorio, S. Otalora, R. Otero, D. Paredes, P. Parra, V. Parra, J.M. Pedrajas, G. Pellejero, D. Pesántez, J.A. Porras, J. Portillo, A. Riera-Mestre, A. Rivas, F. Rivera, A. Rodríguez-Cobo, C. Rodríguez-Matute, J. Rogado, V. Rosa, C.M. Rubio, P. Ruiz-Artacho, N. Ruiz-Giménez, J. Ruiz-Ruiz, P. Ruiz-Sada, J.C. Sahuquillo, G. Salgueiro, A. Sampériz, J.F. Sánchez-Muñoz-Torrero, T. Sancho, P. Sigüenza, S. Soler, J.M. Suriñach, M.I. Torres, C. Tolosa, J. Trujillo-Santos, F. Uresandi, R. Valle, J.R. Vela, G. Vidal, P. Villares, C. Zamora, P. Gutiérrez, F.J. Vázquez, T. Vanassche, C. Vandenbriele, P. Verhamme, J. Hirmerova, R. Malý, I. Benzidia, L. Bertoletti, A. Bura-Riviere, B. Crichi, P. Debourdeau, O. Espitia, D. Farge-Bancel, H. Helfer, I. Mahé, F. Moustafa, G. Poenou, S. Schellong, A. Braester, B. Brenner, I. Tzoran, F. Bilora, B. Brandolin, E. Bucherini, M. Ciammaichella, D. Colaizzo, P. Di Micco, E. Grandone, D. Marchi, D. Mastroiacovo, R. Maida, F. Pace, R. Pesavento, P. Prandoni, R. Quintavalla, N. Rinzivillo, A. Rocci, C. Siniscalchi, A. Tufano, A. Visonà, B. Zalunardo, V. Gibietis, D. Kigitovica, A. Skride, M. Ferreira, S. Fonseca, F. Martins, J. Meireles, M. Bosevski, G. Krstevski, H. Bounameaux, L. Mazzolai, J.A. Caprini, A.J. Tafur, I. Weinberg, H. Wilkins, H.M. Bui, Exposito-Ruiz, M., Arcelus, J. I., Caprini, J. A., Lopez-Espada, C., Bura-Riviere, A., Amado, C., Loring, M., Mastroiacovo, D., Monreal, M., Prandoni, P., Brenner, B., Farge-Bancel, D., Barba, R., Di Micco, P., Bertoletti, L., Schellong, S., Tzoran, I., Reis, A., Bosevski, M., Bounameaux, H., Maly, R., Verhamme, P., Bui, H. M., Adarraga, M. D., Agud, M., Aibar, J., Aibar, M. A., Baeza, C., Ballaz, A., Barbagelata, C., Barron, M., Barron-Andres, B., Blanco-Molina, A., Botella, E., Camon, A. M., Campos, S., Canas, I., Casado, I., Castro, J., Criado, J., de Ancos, C., de Miguel, J., Toro, J. D., Demelo-Rodriguez, P., Diaz-Pedroche, C., Diaz-Peromingo, J. A., Diez-Sierra, J., Dominguez, I. M., Escribano, J. C., Falga, C., Farfan, A. I., Fernandez de Roitegui, K., Fernandez-Aracil, C., Fernandez-Capitan, C., Fernandez-Reyes, J. L., Fidalgo, M. A., Flores, K., Font, C., Font, L., Francisco, I., Furest, I., Gabara, C., Galeano-Valle, F., Garcia, M. A., Garcia-Bragado, F., Garcia-Hernaez, R., Garcia-Raso, A., Gavin-Sebastian, O., Gil-Diaz, A., Gomez-Cuervo, C., Gonzalez-Martinez, J., Grau, E., Gimenez-Suau, M., Guirado, L., Gutierrez, J., Hernandez-Blasco, L., Hernando, E., Herreros, M., Jara-Palomares, L., Jaras, M. J., Jimenez, D., Jimenez, R., Joya, M. D., Jou, I., Lalueza, A., Lecumberri, R., Lima, J., Llamas, P., Lobo, J. L., Lopez-Jimenez, L., Lopez-Miguel, P., Lopez-Nunez, J. J., Lopez-Reyes, R., Lopez-Saez, J. B., Lorenzo, A., Madridano, O., Maestre, A., Marchena, P. J., Martin del Pozo, M., Martin-Martos, F., Mella, C., Mellado, M., Mercado, M. I., Moises, J., Morales, M. V., Munoz-Blanco, A., Munoz-Guglielmetti, D., Munoz-Rivas, N., Nieto, J. A., Nunez-Ares, A., Nunez-Fernandez, M. J., Obispo, B., Olivares, M. C., Orcastegui, J. L., Ortega-Recio, M. 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Subjects
Adult, Male, Registrie, medicine.medical_specialty, Time Factors, Time Factor, Duration of risk, 030204 cardiovascular system & hematology, Drug Administration Schedule, 03 medical and health sciences, Postoperative Complications, 0302 clinical medicine, Risk Factors, Deep vein thrombosi, Interquartile range, medicine, Humans, Registries, cardiovascular diseases, 030212 general & internal medicine, Aged, Venous Thrombosis, Benign disease, business.industry, Risk Factor, Incidence (epidemiology), Pulmonary embolism, Anticoagulant, Anticoagulants, Venous Thromboembolism, Heparin, Low-Molecular-Weight, Middle Aged, equipment and supplies, medicine.disease, Thrombosis, Surgery, Time course, Thromboprophylaxi, Female, Postoperative Complication, Cardiology and Cardiovascular Medicine, business, Venous thromboembolism, Human, Surgical patients
Abstract

Background Venous thromboembolism (VTE) is a major cause of morbidity and mortality postoperatively. The use of pharmacologic prophylaxis is effective in reducing the incidence of VTE. However, the prophylaxis is often discontinued at hospital discharge, especially for those with benign disease. The implications of this practice are not known. We assessed the data from a large, ongoing registry regarding the time course of VTE and outcomes after noncancer surgery. Methods We analyzed the RIETE (Computerized Registry on Venous Thromboembolism) registry, which includes data from consecutive patients with symptomatic confirmed VTE. In the present study, we focused on general surgical patients who had developed symptomatic postoperative VTE in the first 8 weeks after noncancer surgery. The main objective was to assess the interval between surgery and the occurrence of VTE. Additional variables included the clinical presentation associated with the event, the use of thrombosis prophylaxis, and unfavorable outcomes. Results The data from 3296 patients were analyzed. The median time from surgery to the detection of VTE was 16 days (interquartile range, 8-30 days). Of the VTE events, 77% were detected after the first postoperative week and 27% after 4 weeks. Overall, 43.9% of the patients with VTE had received pharmacologic prophylaxis after surgery for a median of 8 days (interquartile range, 5-14 days), and three quarters of the VTE events were detected after pharmacologic prophylaxis had been discontinued. Overall, 54% of the patients with VTE had presented with pulmonary embolism. For 15% of the patients, the clinical outcome was unfavorable, including 4% who had died within 90 days. Conclusions The risk of VTE after noncancer general surgery remains high for ≤2 months. More than one half of the patients had presented with symptomatic PE as the VTE event, and 15% had had unfavorable outcomes. Only 44% of these patients had received pharmacologic prophylaxis for around 1 week.

Published
2021

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