Publication

Management and outcome of major bleeding in patients receiving vitamin K antagonists for venous thromboembolism

RIETE Investigators, Moustafa, F., Stehouwer, A., Kamphuisen, P., Carles Sahuquillo, J., Samperiz, A., Alfonso, M., Pace, F., Maria Surinach, J., Blanco-Molina, A., Mismetti, P. & Monreal, M., Nov-2018, In : Thrombosis Research. 171, p. 74-80 7 p.

Research output: Contribution to journalArticleAcademicpeer-review

APA

RIETE Investigators, Moustafa, F., Stehouwer, A., Kamphuisen, P., Carles Sahuquillo, J., Samperiz, A., ... Monreal, M. (2018). Management and outcome of major bleeding in patients receiving vitamin K antagonists for venous thromboembolism. Thrombosis Research, 171, 74-80. https://doi.org/10.1016/j.thromres.2018.09.049

Author

RIETE Investigators ; Moustafa, Fares ; Stehouwer, Alexander ; Kamphuisen, Pieter ; Carles Sahuquillo, Joan ; Samperiz, Angel ; Alfonso, Maria ; Pace, Federica ; Maria Surinach, Jose ; Blanco-Molina, Angeles ; Mismetti, Patrick ; Monreal, Manuel. / Management and outcome of major bleeding in patients receiving vitamin K antagonists for venous thromboembolism. In: Thrombosis Research. 2018 ; Vol. 171. pp. 74-80.

Harvard

RIETE Investigators, Moustafa, F, Stehouwer, A, Kamphuisen, P, Carles Sahuquillo, J, Samperiz, A, Alfonso, M, Pace, F, Maria Surinach, J, Blanco-Molina, A, Mismetti, P & Monreal, M 2018, 'Management and outcome of major bleeding in patients receiving vitamin K antagonists for venous thromboembolism', Thrombosis Research, vol. 171, pp. 74-80. https://doi.org/10.1016/j.thromres.2018.09.049

Standard

Management and outcome of major bleeding in patients receiving vitamin K antagonists for venous thromboembolism. / RIETE Investigators; Moustafa, Fares; Stehouwer, Alexander; Kamphuisen, Pieter; Carles Sahuquillo, Joan; Samperiz, Angel; Alfonso, Maria; Pace, Federica; Maria Surinach, Jose; Blanco-Molina, Angeles; Mismetti, Patrick; Monreal, Manuel.

In: Thrombosis Research, Vol. 171, 11.2018, p. 74-80.

Research output: Contribution to journalArticleAcademicpeer-review

Vancouver

RIETE Investigators, Moustafa F, Stehouwer A, Kamphuisen P, Carles Sahuquillo J, Samperiz A et al. Management and outcome of major bleeding in patients receiving vitamin K antagonists for venous thromboembolism. Thrombosis Research. 2018 Nov;171:74-80. https://doi.org/10.1016/j.thromres.2018.09.049


BibTeX

@article{4792010d53e341afb1c879ff4bff578a,
title = "Management and outcome of major bleeding in patients receiving vitamin K antagonists for venous thromboembolism",
abstract = "Background: The optimal management of major bleeding in patients receiving vitamin K antagonists (VKA) for venous thromboembolism (VTE) is unclear.Methods: We used the RIETE (Registro Informatizado Enfermedad TromboEmbolica) registry to assess the management and 30-day outcomes after major bleeding in patients receiving VKA for VTE.Results: From January 2013 to December 2017, 267 of 18,416 patients (1.4{\%}) receiving long-term VKA for VTE had a major bleeding (in the gastrointestinal tract 78, intracranial 72, hematoma 50, genitourinary 20, other 47). Overall, 151 patients (57{\%}) received blood transfusion; 110 (41{\%}) vitamin K; 37 (14{\%}) fresh frozen plasma; 29 (11{\%}) pro-haemostatic agents and 20 (7.5{\%}) a vena cava filter. During the first 30 days, 59 patients (22{\%}) died (41 died of bleeding) and 13 (4.9{\%}) had a thrombosis. On multivariable analysis, patients with intracranial bleeding (hazard ratio [HR]: 4.58; 95{\%} CI: 2.40-8.72) and those with renal insufficiency at baseline (HR: 2.73; 95{\%} CI: 1.45-5.15) had an increased mortality risk, whereas those receiving vitamin K had a lower risk (HR: 0.47; 0.24-0.92). On the other hand, patients receiving fresh frozen plasma were at increased risk for thrombotic events (HR: 4.22; 95{\%} CI: 1.25-14.3).Conclusions: Major bleeding in VTE patients receiving VKA carries a high mortality rate. Intracranial bleeding and renal insufficiency increased the risk. Fresh frozen plasma seems to increase this risk for recurrent VTE.",
keywords = "PROTHROMBIN COMPLEX CONCENTRATE, ANTICOAGULANT-THERAPY, PULMONARY-EMBOLISM, REVERSAL, PLASMA, WARFARIN, RISK, DABIGATRAN, SAFETY",
author = "{RIETE Investigators} and Fares Moustafa and Alexander Stehouwer and Pieter Kamphuisen and {Carles Sahuquillo}, Joan and Angel Samperiz and Maria Alfonso and Federica Pace and {Maria Surinach}, Jose and Angeles Blanco-Molina and Patrick Mismetti and Manuel Monreal",
year = "2018",
month = "11",
doi = "10.1016/j.thromres.2018.09.049",
language = "English",
volume = "171",
pages = "74--80",
journal = "Thrombosis Research",
issn = "0049-3848",
publisher = "PERGAMON-ELSEVIER SCIENCE LTD",

}

RIS

TY - JOUR

T1 - Management and outcome of major bleeding in patients receiving vitamin K antagonists for venous thromboembolism

AU - RIETE Investigators

AU - Moustafa, Fares

AU - Stehouwer, Alexander

AU - Kamphuisen, Pieter

AU - Carles Sahuquillo, Joan

AU - Samperiz, Angel

AU - Alfonso, Maria

AU - Pace, Federica

AU - Maria Surinach, Jose

AU - Blanco-Molina, Angeles

AU - Mismetti, Patrick

AU - Monreal, Manuel

PY - 2018/11

Y1 - 2018/11

N2 - Background: The optimal management of major bleeding in patients receiving vitamin K antagonists (VKA) for venous thromboembolism (VTE) is unclear.Methods: We used the RIETE (Registro Informatizado Enfermedad TromboEmbolica) registry to assess the management and 30-day outcomes after major bleeding in patients receiving VKA for VTE.Results: From January 2013 to December 2017, 267 of 18,416 patients (1.4%) receiving long-term VKA for VTE had a major bleeding (in the gastrointestinal tract 78, intracranial 72, hematoma 50, genitourinary 20, other 47). Overall, 151 patients (57%) received blood transfusion; 110 (41%) vitamin K; 37 (14%) fresh frozen plasma; 29 (11%) pro-haemostatic agents and 20 (7.5%) a vena cava filter. During the first 30 days, 59 patients (22%) died (41 died of bleeding) and 13 (4.9%) had a thrombosis. On multivariable analysis, patients with intracranial bleeding (hazard ratio [HR]: 4.58; 95% CI: 2.40-8.72) and those with renal insufficiency at baseline (HR: 2.73; 95% CI: 1.45-5.15) had an increased mortality risk, whereas those receiving vitamin K had a lower risk (HR: 0.47; 0.24-0.92). On the other hand, patients receiving fresh frozen plasma were at increased risk for thrombotic events (HR: 4.22; 95% CI: 1.25-14.3).Conclusions: Major bleeding in VTE patients receiving VKA carries a high mortality rate. Intracranial bleeding and renal insufficiency increased the risk. Fresh frozen plasma seems to increase this risk for recurrent VTE.

AB - Background: The optimal management of major bleeding in patients receiving vitamin K antagonists (VKA) for venous thromboembolism (VTE) is unclear.Methods: We used the RIETE (Registro Informatizado Enfermedad TromboEmbolica) registry to assess the management and 30-day outcomes after major bleeding in patients receiving VKA for VTE.Results: From January 2013 to December 2017, 267 of 18,416 patients (1.4%) receiving long-term VKA for VTE had a major bleeding (in the gastrointestinal tract 78, intracranial 72, hematoma 50, genitourinary 20, other 47). Overall, 151 patients (57%) received blood transfusion; 110 (41%) vitamin K; 37 (14%) fresh frozen plasma; 29 (11%) pro-haemostatic agents and 20 (7.5%) a vena cava filter. During the first 30 days, 59 patients (22%) died (41 died of bleeding) and 13 (4.9%) had a thrombosis. On multivariable analysis, patients with intracranial bleeding (hazard ratio [HR]: 4.58; 95% CI: 2.40-8.72) and those with renal insufficiency at baseline (HR: 2.73; 95% CI: 1.45-5.15) had an increased mortality risk, whereas those receiving vitamin K had a lower risk (HR: 0.47; 0.24-0.92). On the other hand, patients receiving fresh frozen plasma were at increased risk for thrombotic events (HR: 4.22; 95% CI: 1.25-14.3).Conclusions: Major bleeding in VTE patients receiving VKA carries a high mortality rate. Intracranial bleeding and renal insufficiency increased the risk. Fresh frozen plasma seems to increase this risk for recurrent VTE.

KW - PROTHROMBIN COMPLEX CONCENTRATE

KW - ANTICOAGULANT-THERAPY

KW - PULMONARY-EMBOLISM

KW - REVERSAL

KW - PLASMA

KW - WARFARIN

KW - RISK

KW - DABIGATRAN

KW - SAFETY

U2 - 10.1016/j.thromres.2018.09.049

DO - 10.1016/j.thromres.2018.09.049

M3 - Article

VL - 171

SP - 74

EP - 80

JO - Thrombosis Research

JF - Thrombosis Research

SN - 0049-3848

ER -

ID: 76461326