Blood Coagulation, Fibrinolysis and Cellular Haemostasis
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Effect of the time of diagnosis on outcome in patients with acute venous thromboembolism
Findings from the RIETE Registry
Ramón Lecumberri
1
Department of Haematology, Clínica Universitaria de Navarra, Pamplona, Navarra, Spain
,
Silvia Soler
2
Department of Internal Medicine, Hospital Sant Jaume d’Olot, Gerona, Spain
,
Jorge Del Toro
3
Department of Internal Medicine, Hospital General Universitario Gregorio Marañon,
Madrid, Spain
,
Raquel Barba
4
Department of Internal Medicine, Hospital Infanta Cristina, Madrid, Spain
,
Vladimir Rosa
5
Department of Internal Medicine, Hospital Universitario Virgen de la Arrixaca, Murcia,
Spain
,
Maurizio M. Ciammaichella
6
Department of Internal Medicine, Ospedale St. John, Rome, Italy
,
Manuel Monreal
1
Department of Haematology, Clínica Universitaria de Navarra, Pamplona, Navarra, Spain
,
the RIETE Investigators› Author Affiliations Financial support: This project has been partially supported by the Plan Nacional de I+D+I 2008–2011
and the ISCIII-Subdirección General de Evaluación y Fomento de la Investigación (Reference
number: PI080902).
The influence of the day of diagnosis (weekends vs. weekdays) on outcome in patients
with acute venous thromboembolism (VTE) has not been thoroughly studied. We used the
RIETE database to compare the clinical characteristics, treatment details, and mortality
rate at 7 and 30 days, of all patients diagnosed with acute VTE on weekends versus
those diagnosed on weekdays. Up to January 2010, 30,394 patients were included in
RIETE, of whom 5,479 (18%) were diagnosed on weekends. Most clinical characteristics
were similar in both groups, but patients diagnosed on weekends had less often cancer
(20% vs. 22%; p=0.004), and presented more likely with pulmonary embolism (PE) than
those diagnosed on weekdays (52% vs. 47%; p <0.001). Most patients in both groups
received initial therapy with low-molecular-weight heparin (90% and 91%, respectively;
p=0.01), then switched to vitamin K antagonists (72% and 71%, respectively; p=0.007).
The 7-day mortality rate in patients presenting with PE was 2.75% in those diagnosed
on weekends versus 3.00% in those diagnosed on weekdays (p=0.49). At 30 days, the
mortality rate was 6.51% versus 6.06%, respectively (p=0.38). In patients presenting
with deep vein thrombosis alone, the 7-day mortality rate in those diagnosed on weekends
was 1.04% versuss 0.66% in those diagnosed on weekdays (p=0.053). The mortality rate
at 30 days was of 3.41% versus 2.88% (p=0.14), respectively. In RIETE, the clinical
characteristics, treatment strategies, and 7– and 30-day mortality rates of patients
diagnosed on weekends were similar to those in patients diagnosed on weekdays.
5
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