Abstract| Volume 35, ISSUE 2, P230, August 2008

Clinical Outcome of Patients with Upper-Extremity Deep Vein Thrombosis

Muñoz JF, Mismetti P, Poggio R, et al. Chest 2008;133:143–8
      This study used data from an international multi-center registry called RIETE that is prospectively collecting consecutive patients presenting with symptomatic, acute deep vein thrombosis (DVT) or pulmonary embolism (PE) confirmed by objective tests. The authors analyzed demographic characteristics, treatment, and 3-month clinical outcomes of patients with upper-extremity (UE) DVT and lower-extremity (LE) DVT. The study evaluated 11,564 patients in the registry, of whom 512 (4.4%) had UE DVT. Patients with UE DVT presented with PE less often (9.0% vs. 29%, respectively) compared to those with LE DVT. Of the 512 patients with UE DVT, 196 patients (38%) had cancer and 228 patients (45%) had catheter-related DVT. At 3-month follow-up, patients with cancer-related UE DVT had increased incidence of major bleeding, recurrent venous thromboembolism, and death when compared to non-cancer-related UE DVT. The authors concluded that although UE DVT may not present with PE as often as LE DVT, there is significant morbidity and mortality associated with UE DVT, particularly in patients with cancer-related UE DVT.
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