rss
Evid Based Med 13:154 doi:10.1136/ebm.13.5.154
  • Prognosis

Risk of fatal pulmonary embolism was 0.49 per 100 person-years after discontinuing anticoagulant therapy for venous thromboembolism

J D Douketis

Dr J D Douketis, St Joseph's Healthcare, Hamilton, Ontario, Canada; jdouket@mcmaster.ca

STUDY QUESTIONS

In patients who have discontinued anticoagulant therapy after a first episode of venous thromboembolism (VTE), what is the risk of fatal pulmonary embolism (PE) and what is the case-fatality rate of recurrent VTE?

STUDY DESIGN

Design:

combined analysis of 2 inception cohorts followed for a mean 54 (range 1–120) months.

Setting:

3 hospitals in Italy (cohort study) and 16 centres in Sweden (randomised trial).

Patients:

1628 patients from the cohort study and 424 patients from the randomised trial (mean age 62 y, 53% women) who had completed ⩾3 (mean 6) months of anticoagulant therapy (unfractionated or low-molecular-weight heparin for 5–10 d, followed by a vitamin K antagonist) after a first episode of symptomatic, objectively confirmed VTE. Patients with active cancer, …