Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Oct 19:16:437-443.
doi: 10.2147/VHRM.S264814. eCollection 2020.

The Cumulative Incidence and Risk Factors of Recurrent Venous Thromboembolism in the Elderly

Fahad A S Aleidan  1   2
Affiliations

The Cumulative Incidence and Risk Factors of Recurrent Venous Thromboembolism in the Elderly

Fahad A S Aleidan. Vasc Health Risk Manag. .

Abstract

Background: Incidence and outcomes of recurrent venous thromboembolism (VTE) in the elderly are still not fully elucidated. The purpose of this study was to determine the incidence and identify the risk factors of VTE recurrence in this population.

Methods: A prospective cohort study of a one-year follow-up of 277 patients aged ≥65 years with primary VTE was performed at King Abdulaziz Medical City, a tertiary care teaching hospital in Riyadh, Saudi Arabia. Demographic data, risk factors, and the consequences of VTE (recurrence, bleeding, and mortality) were recorded.

Results: Of the 277 VTE patients, 39 (14%) were diagnosed with recurrent VTE over a median follow-up period of 12 months. The cumulative incidence of recurrent VTE was 12.75 per hundred patient-year (95% CI, 8.24-17.36). In multivariate Cox regression, malignancy (hazard ratio [HR], 2.87, 95% CI, 1.32-6.24, p=0.008) and surgery (HR 2.78, 95% CI, 1.36-5.67, p=0.005) were identified as independent risk factors for recurrent VTE. Metformin had a significant independent protection effect (HR, 0.16, 95% CI, 0.08-0.33, p<0.001). During follow-up, two patients in the recurrent VTE group and five patients in the group with no recurrent VTE, all of whom were minor bleeding cases, reported no major bleeding. Seven (18%) patients in the recurrent VTE group and nine (4%) patients in the group with no recurrent VTE died (p<0.001).

Conclusion: The findings of this study show that elderly patients with initial VTE have a recurrent rate (14%), with a cumulative incidence rate of 12.75 per hundred patient-year. Malignancy and surgery were the most important clinical risk factors to impact significantly the development of recurrent VTE in our elderly population. Metformin may have a protective effect against recurrent VTE in the elderly population, and a larger study is needed to validate our findings.

Keywords: elderly; incidence; recurrence; risk factors; venous thromboembolism.

PubMed Disclaimer

Conflict of interest statement

The author declares that he has no conflict of interest.

Figures

Figure 1
Figure 1
Kaplan–Meier recurrence probabilities curve.
See this image and copyright information in PMC

References

    1. Kahn SR, Lim W, Dunn AS. Prevention of VTE in nonsurgical patients: antithrombotic therapy and prevention of thrombosis: American College of chest physicians evidence-based clinical practice guidelines. Chest. 2012;141(suppl2):e195S–e226S. doi: 10.1378/chest.11-2296 - DOI - PMC - PubMed
    1. Anderson FA, Wheeler HB, Goldberg RJ, et al. A population-based perspective of the hospital incidence and case-fatality rates of deep vein thrombosis and pulmonary embolism: the Worcester DVT study. Arch Intern Med. 1991;151:933–938. doi: 10.1001/archinte.1991.00400050081016 - DOI - PubMed
    1. Stein PD, Hull RD, Kayali F, Ghali WA, Alshab AK, Olson RE. Venous thromboembolism according to age: the impact of an aging population. Arch Intern Med. 2004;164:2260–2265. - PubMed
    1. Engbers MJ, Hylckama AV, Rosendaal FR. Venous thrombosis in the elderly: incidence, risk factors and risk groups. J Thromb Haemost. 2010;8:2105–2112. doi: 10.1111/j.1538-7836.2010.03986.x - DOI - PubMed
    1. Bauersachs RM. Use of anticoagulants in elderly patients. Thromb Res. 2012;129:107–115. doi: 10.1016/j.thromres.2011.09.013 - DOI - PubMed