Therapeutic approach for patients with venous thromboembolism attended in emergency departments during routine clinical practice: the EDITH study

J Comp Eff Res. 2018 Apr;7(4):319-330. doi: 10.2217/cer-2017-0061. Epub 2018 Mar 23.

Abstract

Aim: To analyze treatment at discharge/follow-up of patients diagnosed with venous thromboembolism (VTE) in the emergency department (ED).

Materials & methods: Ambispective study (50 Spanish centers) of consecutive patients (October-December 2014) with VTE diagnosed in ED.

Results: VTE was diagnosed in 775 patients (295 pulmonary embolism [PE] without deep vein thrombosis [DVT], 389 DVT without PE and 91 PE + DVT); 95.5% received anticoagulants (90.7% low-molecular-weight heparin [LMWH], 4% LMWH + vitamin K antagonists and <1% direct oral anticoagulants). Overall, 23.3% were discharged from ED and 74.5% hospitalized (98.6% with PE and 50.4% with DVT). After discharge/90/180 days, 43.6/21.0/13.5% were taking LMWH, with similar rates in nononcologic patients.

Conclusion: There is a poor adherence to international guidelines in management of VTE patients in Spain.

Keywords: deep vein thrombosis; direct oral anticoagulants; emergency department; low-molecular-weight heparin; pulmonary embolism; venous thromboembolism; vitamin K antagonists.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Anticoagulants / administration & dosage
  • Anticoagulants / adverse effects
  • Clinical Protocols
  • Emergency Service, Hospital*
  • Female
  • Heparin, Low-Molecular-Weight / administration & dosage
  • Heparin, Low-Molecular-Weight / adverse effects
  • Humans
  • Male
  • Middle Aged
  • Outcome Assessment, Health Care
  • Pulmonary Embolism
  • Spain
  • Venous Thromboembolism / drug therapy*
  • Venous Thrombosis

Substances

  • Anticoagulants
  • Heparin, Low-Molecular-Weight