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Adverse outcomes in patients with venous thromboembolic disease from a rural population.

Calvo-Romero JM, Lima-Rodríguez EM

Internal Medicine Service, Hospital Ciudad de Coria; and Family Medicine, Area de Salud de Coria (Cáceres), Spain. jmcalvo@orangemail.es

OBJECTIVE: To study the adverse outcomes and its predictors during anticoagulant therapy in patients with venous thromboembolic disease (VTD) from a rural population. METHODS: This is a prospective observational study of 94 consecutive patients. The patients were diagnosed in a first-level hospital from a rural Spanish area using objective methods of VTD. RESULTS: The mean follow-up with anticoagulant therapy was 7.1 months (range: 0-29 months). Eighteen patients (19.1%) had an adverse outcome: 10 (10.6%) during the first month and 8 (8.5%) after the first month. Sixteen patients (17%) died, 6 (6.4%) had a major hemorrhage, and 4 (4.3%) had a thromboembolic recurrence. Comorbidity, cancer, nonidiopathic VTD, and pulmonary thromboembolism were significantly associated with adverse outcomes. CONCLUSIONS: Adverse outcomes during anticoagulant therapy are frequent in patients from a rural population with VTD. These adverse outcomes occur frequently during the first month of treatment and are associated with the patient's prior status and the presence of pulmonary thromboembolism.

Published 5 June 2008 in South Med J, 101(6): 601-3.
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