Venous Thromboembolism Associated With Short and Long Term Increase In Mortality

Kirstine Kobberøe Søgaard, MD Department of Clinical Epidemiology, Aarhus University Hospital, DenmarkMedicalResearch.com Interview with:
Kirstine Kobberøe Søgaard, MD
Department of Clinical Epidemiology,
Aarhus University Hospital, Denmark

Medical Research: What are the main findings of the study?

Response: Venous thromboembolism (VTE) is mainly considered an acute illness with a high mortality right after the event, whereas knowledge on the impact on long-term survival has been sparse. In our study, we used nationwide data on VTE since 1977, and included 128,223 patients with VTE and 640,760 individuals from the general population without a VTE diagnosis. We had complete follow-up data on individual patient level and were able to link information from other hospital admissions and thereby obtain each patient’s entire hospital history, as well as death statistics with specific cause of death. We confirmed the high mortality immediately after the thromboembolic event, but more interestingly, we found that mortality remained increased during the entire follow-up period of 30 years, with venous thromboembolism as an important cause of death among patients with deep venous thrombosis and/or pulmonary embolism.

Medical Research: Were any of the findings unexpected?

Response: During the study period, we observed no decrease in mortality in patients with deep venous thrombosis, whereas 1-year mortality in patients with pulmonary embolism was markedly reduced over the last three decades. This reduction may reflect an improvement in the treatment of venous thromboembolism, but it is also likely that enhanced diagnostic procedures (identifying less serious embolisms) had an impact. While deep venous thrombosis and pulmonary embolism were likely to be the cause of death in the short term, this finding persisted even 11-30 years after diagnosis.

Medical Research: What should clinicians and patients take away from your report?

Response: VTE is not only an acute disease, but is also associated with an increased mortality in the long term. Some of these deaths may be prevented if we learn more about optimizing the treatment of venous thromboembolism, as well as reducing the risk of venous thromboembolism recurrence.

Medical Research: What recommendations do you have for future research as a result of this study?

Response: The mechanism behind the increased long-term mortality risk in venous thromboembolism patients needs to be further investigated. We believe it is crucial to find out more about which diseases predict and/or mediate long-term mortality, and to gain more knowledge on how treatment may need to be personalized according to patient characteristics.

Citation:

30-Year Mortality Following Venous Thromboembolism: A Population-Based Cohort Study
Kirstine Kobberøe Søgaard,Morten Schmidt,Lars Pedersen,Erzsébet Horváth-Puhó,and Henrik Toft Sørensen

Circulation. 2014;CIRCULATIONAHA.114.009107published online before print June 26 2014, doi:10.1161/CIRCULATIONAHA.114.009107

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