A full list of RIETE investigators is given in the Appendix.
Influence of recent immobilization and recent surgery on mortality in patients with pulmonary embolism
Article first published online: 4 SEP 2012
© 2012 International Society on Thrombosis and Haemostasis
Journal of Thrombosis and Haemostasis
Volume 10, Issue 9, pages 1752–1760, September 2012
How to Cite
NAUFFAL, D., BALLESTER, M., REYES, R. L., JIMÉNEZ, D., OTERO, R., QUINTAVALLA, R., MONREAL, M. and The RIETE Investigators (2012), Influence of recent immobilization and recent surgery on mortality in patients with pulmonary embolism. Journal of Thrombosis and Haemostasis, 10: 1752–1760. doi: 10.1111/j.1538-7836.2012.04829.x
- Issue published online: 4 SEP 2012
- Article first published online: 4 SEP 2012
- Accepted manuscript online: 23 JUN 2012 12:05PM EST
- Received 23 January 2012, accepted 18 June 2012
- pulmonary embolism;
- risk factors;
Summary. Background: The influence of recent immobilization or surgery on mortality in patients with pulmonary embolism (PE) is not well known.
Methods: We used the Registro Informatizado de Enfermedad TromboEmbólica (RIETE) data to compare the 3-month mortality rate in patients with PE, with patients categorized according to the presence of recent immobilization, recent surgery, or neither.
Results: Of 18 028 patients with PE, 4169 (23%) had recent immobilization, 2212 (12%) had recent surgery, and 11 647 (65%) had neither. The all-cause mortality was 10.0% (95% confidence interval [CI] 9.5–10.4), and the PE-related mortality was 2.6% (95% CI 2.4–2.9). One in every two patients who died from PE had recent immobilization (43%) or recent surgery (6.7%). Only 25% of patients with immobilization had received prophylaxis, as compared with 65% of the surgical patients. Fatal PE was more common in patients with recent immobilization (4.9%; 95% CI 4.3–5.6) than in those with surgery (1.4%; 95% CI 1.0–2.0) or those with neither (2.1%; 95% CI 1.8–2.3). On multivariate analysis, patients with immobilization were at increased risk for fatal PE (odds ratio 2.2; 95% CI 1.8–2.7), with no differences being seen between patients immobilized in hospital or in the community.
Conclusions: Forty-three per cent of patients dying from PE had recent immobilization for ≥ 4 days. Many of these deaths could have been prevented.