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This Article Full Text (PDF) Free All Versions of this Article: chest.07-1432v1 133/1/143    most recent Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to My Personal Article Archive Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by José Muñoz, F. Articles by Monreal, M. Search for Related Content PubMed PubMed Citation Articles by José Muñoz, F. Articles by Monreal, M.

Clinical outcome of patients with upper-extremity deep vein thrombosis: Results from the RIETE Registry.

¹Department of Internal Medicine. Hospital de Mollet. Mollet del Vallès. Barcelona. Spain ²Department of Internal Medicine. Hospital Bellevue; EA 3065; INSERM-CIE3; Saint-Etienne. France ³Internal Medicine Thrombosis Center. Hospital Galliera. Genoa. Italy ⁴Department of Internal Medicine. Hospital Sierrallana. Torrelavega. Cantabria. Spain ⁵Department of Pneumology. Complejo Hospitalario San Millán y San Pedro. Logroño. La Rioja. Spain ⁶Department of Internal Medicine. Hospital de la Axarquía. Vélez. Málaga. Spain ⁷Department of Internal Medicine. Hospital Germans Trias i Pujol. Badalona. Barcelona. Spain

mmonreal.germanstrias{at}gencat.net

Abstract

BackgroundThere is little information on the clinical outcome of patients with upper extremity deep vein thrombosis (arm DVT).

MethodsRIETE is an ongoing registry of consecutive patients with objectively confirmed, symptomatic, acute DVT or pulmonary embolism (PE). In this analysis we analyzed the demographic characteristics, treatment and 3-month outcome of all patients with arm DVT.

ResultsOf the 11,564 DVT patients enrolled, 512 (4.4%) had arm DVT. They presented less often with clinically overt PE (9.0% vs. 29%; odds ratio: 0.24; 95% CI: 0.18-0.33) than those with lower limb DVT, but their 3-month outcome was similar. Of the 512 patients with arm DVT, 196 (38%) had cancer, 228 (45%) had catheter-related DVT. During follow-up, those with cancer DVT had an increased incidence of major bleeding (4.1% vs. 0.9%; odds ratio: 4.4; 95% CI: 1.2-21), recurrent VTE (6.1% vs. 2.8%; odds ratio: 2.2; 95% CI: 0.91-5.6; p=0.04), and death (22% vs. 3.5%; odds ratio: 7.8; 95% CI: 4.0-16). Thirty patients had the composite event of recurrent DVT, symptomatic PE or major bleeding. They were significantly older, more often had cancer, and presented more frequently with symptomatic PE on admission. On multivariate analysis, only cancer patients with arm DVT had an increased risk for the composite event (odds ratio: 3.0; 95% CI: 1.4-6.4).

ConclusionsAt presentation patients with arm DVT have less often clinically overt PE than those with lower limb DVT, but their 3-month outcome is similar. Among patients with arm DVT, those with cancer have the worse outcome.

Key Words: venous thromboembolism • upper-extremity • outcome