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12. Bowel obstruction after laparoscopic Roux-en-Y gastric bypass

Author

Nguyen, N T, MD, Huerta, S, Gelfand, D, Stevens, C M, and Jim, J

Subjects
morbid obesity, bariatric surgery, laparoscopy, gastric bypass, bowel obstruction
Abstract

Background: Bowel obstruction has been frequently reported after laparoscopic Roux-en-Y gastric bypass (LRYGBP). The aim of this study was to review our experience with bowel obstruction following LRYGBP, specifically examining its etiology and management and to strategize maneuvers to minimize this complication. Methods: We retrospectively reviewed the charts of 9 patients who developed postoperative bowel obstruction after LRYGBP. Each chart was reviewed for demographics, timing of bowel obstruction from the primary operation, etiology of obstruction, and management. Results: 9 of our initial 225 patients (4%) who underwent LRYGBP developed postoperative bowel obstruction. The mean age was 46 12 years, with mean BMI 47 +/- 9 kg/m(2). 6 patients developed early bowel obstruction, and 3 patients developed late bowel obstruction. The mean time interval for development of early bowel obstruction was 16 16 days. The causes for early bowel obstruction included narrowing of the jejunojenunostomy anastomosis (n=3), angulation of the Roux limb (n=2), and obstruction of the Roux limb at the level of the transverse mesocolon (n=1). The mean time interval for development of late bowel obstruction was 7.4 +/- 0.5 months. The causes for late bowel obstruction included internal herniation (n=2) and adhesions (n=1). 6 of 9 bowel obstructions (66%) were considered technically related to the learning curve of the laparoscopic approach. Eight of the 9 patients required operative intervention, and 6 of the 8 reoperations were managed laparoscopically. Management included laparoscopic bypass of the jejunojejunostomy obstruction site (n=5), open reduction of internal hernia (n=2), and laparoscopic lysis of adhesion (n=1). Conclusions: Bowel obstruction is a frequent complication after LRYGBP, particularly during the learning curve of the laparoscopic approach. Specific measures should be instituted to minimize bowel obstruction after LRYGBP as most of these complications are considered technically preventable.

Published
2004

19. A RIETE registry analysis of recurrent thromboembolism and hemorrhage in patients with catheter-related thrombosis

Author

Monreal, Manuel, Decousus, Hervè, Prandoni, Paolo, Brenner, Benjamin, Barba, Raquel, Di Micco, Pierpaolo, Bertoletti, Laurent, Schellong, Sebastian, Tzoran, Inna, Reis, Abilio, Bosevski, Marijan, Bounameaux, Henri, Malý, Radovan, Wells, Philip, Alcalde, M., Alibalic, A., Arcelus, J.I., Auguet, T., Barba, R., Barrón, M., Barrón-Andrés, B., Bascuñana, J., Benítez, J.F., Blanco-Molina, A., Casado, I., Conget, F., del Molino, F., del Toro, J., Díaz, J.A., Falgá, C., Fernández-Capitán, C., Font, L., Gallego, P., García-Bragado, F., García, A., Gómez-Durán, M., Gómez, V., González, J., Grau, E., Guijarro, R., Gutiérrez, J., Hernández, L., Hernández-Huerta, S., Jara-Palomares, L., Jaras, M.J., Jiménez, D., Jiménez, R., Jiménez, S., Lecumberri, R., Lobo, J.L., López-Jiménez, L., López-Montes, L., López-Reyes, R., López-Sáez, J.B., Lorente, M.A., Lorenzo, A., Macià, M., Madridano, O., Marchena, P.J., Martín-Antorán, J.M., Martín-Martos, F., Monreal, M., Morales, M.V., Muñoz, F.J., Nauffal, D., Nieto, J.A., Núñez, M.J., Otero, R., Pagán, B., Pedrajas, J.M., Pérez-Rus, G., Peris, M.L., Pons, I., Porras, J.A., Riera-Mestre, A., Rivas, A., Rodríguez-Dávila, M.A., Román, P., Rosa, V., Ruiz-Giménez, N., Sabio, P., Sampériz, A., Sánchez, R., Sanz, O., Soler, S., Sopeña, B., Soto, M.J., Suriñach, J.M., Tiberio, G., Tirado, R., Trujillo-Santos, J., Uresandi, F., Valero, B., Valle, R., Vela, J., Vilella-Tomas, V., Villalobos, A., Villalta, J., Malfante, P., Verhamme, P., Vanassche, T., Wells, P., Malý, R., Hirmerova, J., Bertoletti, L., Bura-Riviere, A., Moustafa, F., Farge-Bancel, D., Hij, A., Mahe, I., Merah, A., Quere, I., Schellong, S., Braester, A., Brenner, B., Tzoran, I., Apollonio, A., Barillari, G., Ciammaichella, M., Valle, F., Di Micco, P., Ferrazzi, P., Guida, A., Maida, R., Pace, F., Pasca, S., Piovella, C., Prandoni, P., Re, R., Rota, L., Tonello, D., Tufano, A., Visonà, A., Zalunardo, B., Malheiro, J., Ribeiro, J.L., Sousa, M.S., Bosevski, M., Zdraveska, M., Alatri, A., Bounameaux, H., Calanca, L., Mazzolai, L., Caprini, J., Serrano, J.C., Baumann Kreuziger, Lisa, Cote, Lauren, Verhamme, Peter, Greenberg, Steven, Caprini, Joseph, Muñoz, Francisco José, Valle, Reina, and Monreal Bosch, Manuel

Published
2015
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20. Subsequent arterial ischemic events in patients receiving anticoagulant therapy for venous thromboembolism

Author

Arcelus, J.I., Arroyo, M., Ballaz, A., Barba, R., Barrón, M., Barrón-Andrés, B., Bascuñana, J., Bedate, P., Blanco-Molina, A., Bueso, T., Casado, I., del Molino, F., del Toro, J., Falgá, C., Fernández-Capitán, C., Font, C., Fuentes, M.I., Gallego, P., García-Bragado, F., Gavín, O., Gómez, V., González, J., González-Bachs, E., Grau, E., Guil, M., Guijarro, R., Gutiérrez, J., Hernández, L., Hernández-Huerta, S., Jara-Palomares, L., Jaras, M.J., Jiménez, D., Lecumberri, R., Lobo, J.L., López-Jiménez, L., López-Sáez, J.B., Lorente, M.A., Lorenzo, A., Luque, J.M., Madridano, O., Macià, M., Maestre, A., Marchena, P.J., Martín, M., Martín-Villasclaras, J.J., Monreal, M., Mora, J.M., Mosquera, D., Muñoz, F.J., Nauffal, M.D., Nieto, J.A., Núñez, M.J., Ogea, J.L., Otero, R., Pedrajas, J.M., Peris, M.L., Riera-Mestre, A., Rivas, A., Rodríguez-Dávila, M.A., Román, P., Rosa, V., Ruiz, J., Ruiz-Gamietea, A., Ruiz-Giménez, N., Sahuquillo, J.C., Samperiz, A., Sánchez Muñoz-Torrero, J.F., Soler, S., Suriñach, J.M., Tiberio, G., Tilvan, R.M., Tolosa, C., Trujillo, J., Uresandi, F., Valdés, M., Valero, B., Valle, R., Vela, J., Vidal, G., Vilar, C., Villalobos, A., Villalta, J., Malý, R., Hirmerova, J., Miklo sová, M., Salgado, E., Bertoletti, L., Bura-Riviere, A., Farge-Bancel, D., Mahe, I., Merah, A., Quere, I., Schellong, S., Babalis, D., Papadakis, M., Tzinieris, I., Braester, A., Brenner, B., Tzoran, I., Zeltser, D., Barillari, G., Ciammaichella, M., Di Micco, P., Duce, R., Maida, R., Dalla Valle, F., Piovella, C., Poggio, R., Prandoni, P., Quintavalla, R., Rota, L., Schenone, A., Tiraferri, E., Tonello, D., Tufano, A., Visonà, A., Zalunardo, B., Fernandes, M., Gonçalves, F., Santos, M., Saraiva, M., Sousa, R., Bosevski, M., Kovacevic, D., Alatri, A., Aujeski, D., Bounameaux, H., Calanca, L., Mazzolai, L., Madridano, Olga, del Toro, Jorge, Lorenzo, Alicia, Martín, Mar, Gómez Cerezo, Jorge, Hernández, Luis, Prandoni, Paolo, and Monreal, Manuel

Published
2015
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24. Estudio geomorfológico, hidrogeoquímico, isotópico, gravimétrico y Dinsar en depósitos criogénicos de las nacientes del río Hurtado, región de Coquimbo, Chile

Author

Fuentes, F, Olea, P., Donoso, C., Cifuentes, J.L., Ortiz, M., Merino, R.N., Huerta, S., Monserrat, O., Coloma, F., and Fustos, I.

Abstract

Durante la elaboración del mapa Hidrogeológico de la cuenca del río Limarí (Fuentes et al., en preparación) llevado a cabo por la unidad de Hidrogeología del Sernageomin, se ha realizado el proyecto “Estimación del aporte hídrico de las crioformas de la subcuenca del río Hurtado, región de Coquimbo, Chile”, donde se busca estimar el aporte hídrico de las morrenas y glaciares de roca al balance de la cuenca. En este trabajo presentamos los resultados preliminares del mapeo geomorfológico, donde se identificó que el paisaje fue modelado por glaciares blancos, cuyos depósitos morrénicos constituyen el principal relleno de los valles de alta montaña. La morfología actual indica procesos periglaciares incluyendo gelifluxión, crioselección y crioclastía. Dentro de este ambiente se identificaron cerca de 25 glaciares rocosos, lobulados y multilobulados, y numerosos cordones y lóbulos de protalud.

Published
2021
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26. 1722P Prevalence and predictors of breast reconstruction following mastectomy in breast cancer patients treated in a public center in Mexico

Author

Becerril-Gaitan, A., primary, Vaca-Cartagena, B.F., additional, Ferrigno, A.S., additional, Aranda-Gutierrez, A., additional, Roman-Zamudio, M., additional, Acosta-Sandoval, M.A., additional, Torres-Leal, M.I., additional, Gonzalez-Mondellini, F.A., additional, Diaz-Perez, H.M., additional, Cardona-Huerta, S., additional, Ortiz-López, R., additional, and Villarreal-Garza, C., additional

Published
2021
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27. 217P The impact of obesity on the survival outcomes of women with breast cancer that achieve pathological complete response

Author

Roman-Zamudio, M., primary, Gutierrez, A. Aranda, additional, Ferrigno, A.S., additional, Becerril-Gaitan, A., additional, Vaca-Cartagena, B.F., additional, Gonzalez-Mondellini, F.A., additional, Acosta-Sandoval, M.A., additional, Torres-Leal, M.I., additional, Diaz-Perez, H.M., additional, Cardona-Huerta, S., additional, Ortiz-López, R., additional, and Villarreal-Garza, C., additional

Published
2021
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28. 207P Outcomes of patients with triple-negative breast cancer following neoadjuvant chemotherapy with anthracycline and taxane-based regimens plus carboplatin

Author

Vaca-Cartagena, B.F., primary, Becerril-Gaitan, A., additional, Aranda-Gutierrez, A., additional, Ferrigno, A.S., additional, Roman-Zamudio, M., additional, Torres-Leal, M.I., additional, Acosta-Sandoval, M.A., additional, Gonzalez-Mondellini, F.A., additional, Diaz-Perez, H.M., additional, Cardona-Huerta, S., additional, Ortiz-López, R., additional, and Villarreal-Garza, C., additional

Published
2021
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43. Clinical outcome in patients with venous thromboembolism receiving concomitant anticoagulant and antiplatelet therapy

Author

Tzoran I., Brenner B., Sakharov G., Trujillo-Santos J., Lorenzo A., Madridano O., Lopez-Saez J. B., Monreal M., Andujar V., Arcelus J. I., Auguet T., Barba R., Barron M., Barron-Andres B., Bascunana J., Blanco-Molina A., Bueso T., Casado I., Casillas C., Conget F., Del Molino F., Del Toro J., Falga C., Fernandez-Capitan C., Font L., Gallego P., Garcia-Bragado F., Gomez V., Gonzalez J., Gonzalez-Bachs E., Guijarro R., Guil M., Gutierrez J., Hernandez L., Hernandez-Huerta S., Jara-Palomares L., Jaras M. J., Jimenez D., Jimenez R., Lobo J. L., Lopez-Jimenez L., Lopez-Montes L., Lopez-Reyes R., Lorente M. A., Luque J. M., Llutart J., Marchena P. J., Martin M., Martin-Antoran J. M., Mellado M., Nauffal D., Nieto J. A., Ogea J. L., Otero R., Pagan B., Pedrajas J. M., Peris M. L., Porras J. A., Pons I., Riera-Mestre A., Rivas A., Rodriguez-Davila M. A., Roman P., Roncero A., Rosa V., Ruiz-Gimenez N., Ruiz J., Sabio P., Sahuquillo J. C., Samperiz A., Sanchez R., Sanchez Munoz-Torrero J. F., Soler S., Surinach J. M., Tiberio G., Tirado R., Tolosa C., Valero B., Valle R., Vela J., Vidal G., Villalobos A., Vilella V., Malfante P., Villagra M., Vivero F., Verhamme P., Peerlinck K., Maly R., Hirmerova J., Kaletova M., Bertoletti L., Bura-Riviere A., Farge-Bancel D., Grange C., Hij A., Mahe I., Merah A., Quere I., Schellong S., Babalis D., Papadakis M., Tzinieris I., Braester A., Zeltser D., Apollonio A., Barillari G., Ciammaichella M., Di Micco P., Duce R., Guida A., Maida R., Mattei L., Pace F., Piovella C., Pesavento R., Poggio R., Prandoni P., Rota L., Schenone A., Tonello D., Tufano A., Visona A., Zalunardo B., Santos M., Bosevski M., Kovacevic D., Alatri A., Bounameaux H., Calanca L., Mazzolai L., Serrano J. C., Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Caractéristiques féminines des dysfonctions des interfaces cardio-vasculaires (EA 2992), Université Montpellier 1 (UM1)-Université de Montpellier (UM), Tzoran, I., Brenner, B., Sakharov, G., Trujillo-Santos, J., Lorenzo, A., Madridano, O., Lopez-Saez, J. B., Monreal, M., Andujar, V., Arcelus, J. I., Auguet, T., Barba, R., Barron, M., Barron-Andres, B., Bascunana, J., Blanco-Molina, A., Bueso, T., Casado, I., Casillas, C., Conget, F., Del Molino, F., Del Toro, J., Falga, C., Fernandez-Capitan, C., Font, L., Gallego, P., Garcia-Bragado, F., Gomez, V., Gonzalez, J., Gonzalez-Bachs, E., Guijarro, R., Guil, M., Gutierrez, J., Hernandez, L., Hernandez-Huerta, S., Jara-Palomares, L., Jaras, M. J., Jimenez, D., Jimenez, R., Lobo, J. L., Lopez-Jimenez, L., Lopez-Montes, L., Lopez-Reyes, R., Lorente, M. A., Luque, J. M., Llutart, J., Marchena, P. J., Martin, M., Martin-Antoran, J. M., Mellado, M., Nauffal, D., Nieto, J. A., Ogea, J. L., Otero, R., Pagan, B., Pedrajas, J. M., Peris, M. L., Porras, J. A., Pons, I., Riera-Mestre, A., Rivas, A., Rodriguez-Davila, M. A., Roman, P., Roncero, A., Rosa, V., Ruiz-Gimenez, N., Ruiz, J., Sabio, P., Sahuquillo, J. C., Samperiz, A., Sanchez, R., Sanchez Munoz-Torrero, J. F., Soler, S., Surinach, J. M., Tiberio, G., Tirado, R., Tolosa, C., Valero, B., Valle, R., Vela, J., Vidal, G., Villalobos, A., Vilella, V., Malfante, P., Villagra, M., Vivero, F., Verhamme, P., Peerlinck, K., Maly, R., Hirmerova, J., Kaletova, M., Bertoletti, L., Bura-Riviere, A., Farge-Bancel, D., Grange, C., Hij, A., Mahe, I., Merah, A., Quere, I., Schellong, S., Babalis, D., Papadakis, M., Tzinieris, I., Braester, A., Zeltser, D., Apollonio, A., Barillari, G., Ciammaichella, M., Di Micco, P., Duce, R., Guida, A., Maida, R., Mattei, L., Pace, F., Piovella, C., Pesavento, R., Poggio, R., Prandoni, P., Rota, L., Schenone, A., Tonello, D., Tufano, A., Visona, A., Zalunardo, B., Santos, M., Bosevski, M., Kovacevic, D., Alatri, A., Bounameaux, H., Calanca, L., Mazzolai, L., and Serrano, J. C.

Subjects
Male, medicine.medical_specialty, Arterial disease, medicine.drug_class, Hemorrhage, 030204 cardiovascular system & hematology, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Internal Medicine, medicine, Antiplatelet, Humans, In patient, cardiovascular diseases, 030212 general & internal medicine, Aged, business.industry, Anticoagulant, Anticoagulants, Venous Thromboembolism, 3. Good health, Surgery, Treatment Outcome, Increased risk, Anticoagulant therapy, Concomitant, Drug Therapy, Combination, Female, business, Venous thromboembolism, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, Platelet Aggregation Inhibitors, Major bleeding
Abstract

International audience; INTRODUCTION:Patients with arterial disease receiving antiplatelet agents may develop venous thromboembolism (VTE) and need anticoagulant therapy, although concomitant use of these drugs may increase bleeding risk. We analyzed RIETE data and compared clinical outcomes depending on decision to discontinue or maintain antiplatelet therapy at VTE diagnosis.METHODS:Consecutive patients with acute VTE were enrolled in RIETE. Only patients receiving antiplatelet therapy at baseline were included in this analysis. Primary outcomes were: rate of subsequent ischemic events, major bleeding or death during anticoagulation course.RESULTS:1178 patients who received antiplatelet drugs at VTE diagnosis were included. Antiplatelet therapy was discontinued in 62% of patients. During anticoagulation course, patients also receiving antiplatelet therapy had higher rates of lower limb amputations (2.28 vs. 0.21 events per 100 patients-years; p

Published
2014

44. Lactation performance of rural Mesoamerindians

Author

Villalpando, S.F., Butte, N.F., Wong, W.W., Flores-Huerta, S., de Jesus Hernandez-Beltran, M., Smith, E.O., and Garza, C.

Subjects
Mothers -- Food and nutrition, Lactation -- Physiological aspects, South American native peoples -- Health aspects
Abstract

The maternal factors that potentially limit lactation and infant growth were studied among Mesoamerindian women in rural, underprivileged areas living on maize-predominant diets. Human milk production, milk composition, and maternal dietary intake, body weight, skinfold thicknesses and body composition were measured four to six months postpartum. Lactating quality and quantity was found to be a function of anthropometric and body composition measurements and not of the pregnant womens' current diet.

Published
1992

45. Long-Term Anticoagulant Therapy of Patients with Venous Thromboembolism. What Are the Practices?

Author

Mahe, I., Sterpu, R., Bertoletti, L., Lopez-Jimenez, L., Joan, M. M., Trujillo-Santos, J., Ballaz, A., Hernandez Blasco, L. M., Marchena, P. J., Monreal, M., Ameneiro, E., Arcelus, J. I., Barba, R., Barron, M., Barron-Andres, B., Bascunana, J., Blanco-Molina, A., Bueso, T., Casado, I., Conget, F., Del Molino, F., Del Toro, J., Falga, C., Fernandez-Capitan, C., Font, L., Fuentes, M. I., Gallego, P., Garcia-Bragado, F., Garcia-Lorenzo, M. D., Gomez, V., Gonzalez, J., Gonzalez-Bachs, E., Guil, M., Gutierrez, J., Hernandez, L., Hernandez-Huerta, S., Jaras, M. J., Jimenez, D., Lecumberri, R., Lobo, J. L., Lopez-Montes, L., Lopez-Reyes, R., Lopez-Saez, J. B., Lorente, M. A., Lorenzo, A., Luque, J. M., Madridano, O., Martin, M., Mellado, M., Mora, J. M., Nauffal, D., Nieto, J. A., Nunez, M. J., Ogea, J. L., Paul, H., Pedrajas, J. M., Peris, M. L., Porras, J. A., Riera-Mestre, A., Rivas, A., Rodriguez-Davila, M. A., Roman, P., Rosa, V., Ruiz-Gimenez, N., Ruiz, J., Sahuquillo, J. C., Samperiz, A., Sanchez, R., Sanchez Munoz-Torrero, J. F., Soler, S., Surinach, J. M., Tiberio, G., Tilvan, R. M., Tolosa, C., Uresandi, F., Valdes, M., Valero, B., Valle, R., Vela, J., Vidal, G., Vilella, V., Villalta, J., Verhamme, P., Peerlinck, K., Wells, P., Maly, R., Hirmerova, J., Kaletova, M., Bura-Riviere, A., Farge-Bancel, D., Hij, A., Merah, A., Schellong, S., Babalis, D., Papadakis, M., Tzinieris, I., Braester, A., Brenner, B., Tzoran, I., Zeltser, D., Amitrano, M., Apollonio, A., Barillari, G., Ciammaichella, M., Dalla Valle, F., Di Micco, P., Duce, R., Guida, A., Maida, R., Pasca, S., Piovella, C., Prandoni, P., Rota, L., Tiraferri, E., Tonello, D., Tufano, A., Visona, A., Zalunardo, B., Brinquinho, M., Miranda, D., Sousa, M. S., Bosevski, M., Kovacevic, D., Alatri, A., Bounameaux, H., Calanca, L., Mazzolai, L., RIETE Investigators, Ameneiro, E., Arcelus, JI., Ballaz, A., Barba, R., Barrón, M., Barrón-Andrés, B., Bascuñana, J., Blanco-Molina, A., Bueso, T., Casado, I., Conget, F., del Molino, F., del Toro, J., Falgá, C., Fernández-Capitán, C., Font, L., Fuentes, MI., Gallego, P., García-Bragado, F., García-Lorenzo, MD., Gómez, V., González, J., González-Bachs, E., Guil, M., Gutiérrez, J., Hernández, L., Hernández-Huerta, S., Jaras, MJ., Jiménez, D., Lecumberri, R., Lobo, JL., López-Jiménez, L., López-Montes, L., López-Reyes, R., López-Sáez, JB., Lorente, MA., Lorenzo, A., Luque, JM., Madridano, O., Marchena, PJ., Martín, M., Mellado, M., Monreal, M., Mora, JM., Nauffal, D., Nieto, JA., Núñez, MJ., Ogea, JL., Paul, H., Pedrajas, JM., Peris, ML., Porras, JA., Riera-Mestre, A., Rivas, A., Rodríguez-Dávila, MA., Román, P., Rosa, V., Ruiz-Giménez, N., Ruiz, J., Sahuquillo, JC., Samperiz, A., Sánchez, R., Sánchez Muñoz-Torrero JF., Soler, S., Suriñach, JM., Tiberio, G., Tilván, RM., Tolosa, C., Trujillo-Santos, J., Uresandi, F., Valdés, M., Valero, B., Valle, R., Vela, J., Vidal, G., Vilella, V., Villalta, J., Verhamme, P., Peerlinck, K., Wells, P., Malý, R., Hirmerova, J., Kaletova, M., Bertoletti, L., Bura-Riviere, A., Farge-Bancel, D., Hij, A., Mahe, I., Merah, A., Schellong, S., Babalis, D., Papadakis, M., Tzinieris, I., Braester, A., Brenner, B., Tzoran, I., Zeltser, D., Amitrano, M., Apollonio, A., Barillari, G., Ciammaichella, M., Dalla Valle, F., Di Micco, P., Duce, R., Guida, A., Maida, R., Pasca, S., Piovella, C., Prandoni, P., Rota, L., Tiraferri, E., Tonello, D., Tufano, A., Visonà, A., Zalunardo, B., Brinquinho, M., Miranda, D., Bosevski, M., Kovacevic, D., Alatri, A., Bounameaux, H., Calanca, L., Sterpu, R., Lopez-Jimenez, L., Joan, M. M., Hernandez Blasco, L. M., Marchena, P. J., Arcelus, J. I., Barron, M., Barron-Andres, B., Bascunana, J., Del Molino, F., Del Toro, J., Falga, C., Fernandez-Capitan, C., Fuentes, M. I., Garcia-Bragado, F., Garcia-Lorenzo, M. D., Gomez, V., Gonzalez, J., Gonzalez-Bachs, E., Gutierrez, J., Hernandez, L., Hernandez-Huerta, S., Jaras, M. J., Jimenez, D., Lobo, J. L., Lopez-Montes, L., Lopez-Reyes, R., Lopez-Saez, J. B., Lorente, M. A., Luque, J. M., Martin, M., Mora, J. M., Nieto, J. A., Nunez, M. J., Ogea, J. L., Pedrajas, J. M., Peris, M. L., Porras, J. A., Rodriguez-Davila, M. A., Roman, P., Ruiz-Gimenez, N., Sahuquillo, J. C., Sanchez, R., Sanchez Munoz-Torrero, J. F., Surinach, J. M., Tilvan, R. M., Valdes, M., Maly, R., Visona, A., Sousa, M. S., and Mazzolai, L.

Subjects
Male, Time Factors, Vitamin K, lcsh:Medicine, Càncer de ronyó, Deep vein thrombosis, Neoplasms, Antithrombotic, 80 and over, lcsh:Science, Aged, 80 and over, Multidisciplinary, Anticoagulant, Low-Molecular-Weight, Anemia, Venous Thromboembolism, Heparin, Aged, Anticoagulants, Drug Prescriptions, Female, Fibrinolytic Agents, Follow-Up Studies, Guideline Adherence, Heparin, Low-Molecular-Weight, Humans, Middle Aged, 3. Good health, Renal cancer, Cancer treatment, Venous thromboembolism, Research Article, medicine.drug, medicine.medical_specialty, medicine.drug_class, Hemorrhage, Thromboembolism, Internal medicine, medicine, Anticoagulant therapy, Tromboembolisme, Trombosi -- Tractament, business.industry, lcsh:R, Cancer, Odds ratio, medicine.disease, Surgery, Anticoagulants (Medicina), lcsh:Q, Anticoagulants (Medicine), business, Fibrinolytic agent
Abstract

Current guidelines of antithrombotic therapy suggest early initiation of vitamin K antagonists (VKA) in non-cancer patients with venous thromboembolism (VTE), and long-term therapy with low-molecular weight heparin (LMWH) for those with cancer. We used data from RIETE (international registry of patients with VTE) to report the use of long-term anticoagulant therapy over time and to identify predictors of anticoagulant choice (regarding international guidelines) in patients with- and without cancer. Among 35,280 patients without cancer, 82% received long-term VKA (but 17% started after the first week). Among 4,378 patients with cancer, 66% received long term LMWH as monotherapy. In patients without cancer, recent bleeding (odds ratio [OR] 2.70, 95% CI 2.26-3.23), age >70 years (OR 1.15, 95% CI 1.06-1.24), immobility (OR 2.06, 95% CI 1.93-2.19), renal insufficiency (OR 2.42, 95% CI 2.15-2.71) and anemia (OR 1.75, 95% CI 1.65-1.87) predicted poor adherence to guidelines. In those with cancer, anemia (OR 1.83, 95% CI 1.64-2.06), immobility (OR 1.51, 95% CI 1.30-1.76) and metastases (OR 3.22, 95% CI 2.87-3.61) predicted long-term LMWH therapy. In conclusion, we report practices of VTE therapy in real life and found that a significant proportion of patients did not receive the recommended treatment. The perceived increased risk for bleeding has an impact on anticoagulant treatment decision. This Registry is supported by unrestricted educational grants from Sanofi Spain and Bayer Pharma AG. The funding source had no role in the design, protocol development, or conduct of the study; data collection, management, or analysis; interpretation, preparation, review, or approval of the manuscript; or the decision to submit the manuscript for publication. The RIETE Registry was supported with an unrestricted educational grant from Sanofi Spain and Bayer Pharma AG. Bayer Pharma AG’s support was limited to the part of RIETE outside Spain, which accounts for a 20.05% of the total patients included in the RIETE Registry. The authors have nothing to disclose. The authors have declared that no competing interests exist.

Published
2015

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