Prophylaxis of venous thromboembolism in elderly patients with multimorbidity

Maura Marcucci, Alfonso Iorio, Alessandro Nobili, Mauro Tettamanti, Luca Pasina, Codjo Djignefa Djade, Alessandra Marengoni, Francesco Salerno, Salvatore Corrao, Pier Mannuccio Mannucci, Carlotta Franchi, Eleonora Sparacio, Stefania Alborghetti, Rosa Di Costanzo, Domenico Prisco, Elena Silvestri, Caterina Cenci, Tommaso Barnini, Giuseppe Delitala, Stefano CartaSebastiana Atzori, Gianfranco Guarnieri, Michela Zanetti, Annalisa Spalluti, Maria Grazia Serra, Maria Antonietta Bleve, Massimo Vanoli, Giulia Grignani, Gianluca Casella, Laura Gasbarrone, Giorgio Maniscalco, Massimo Gunelli, Daniela Tirotta, Antonio Brucato, Silvia Ghidoni, Paola Di Corato, Mauro Bernardi, Silvia Li Bassi, Luca Santi, Giancarlo Agnelli, Emanuela Marchesini, Elmo Mannarino, Graziana Lupattelli, Pamela Rondelli, Francesco Paciullo, Fabrizio Fabris, Michela Carlon, Francesca Turatto, Maria Cristina Baroni, Marianna Zardo, Roberto Manfredini, Christian Molino, Marco Pala, Fabio Fabbian, Ranuccio Nuti, Roberto Valenti, Martina Ruvio, Silvia Cappelli, Giuseppe Paolisso, Maria Rosaria Rizzo, Maria Teresa Laieta, Teresa Salvatore, Ferdinando Carlo Sasso, Riccardo Utili, Emanuele Durante Mangoni, Daniela Pinto, Oliviero Olivieri, Anna Maria Stanzial, Renato Fellin, Stefano Volpato, Sioulis Fotini, Mario Barbagallo, Ligia Dominguez, Lidia Plances, Daniela D’Angelo, Giovanbattista Rini, Pasquale Mansueto, Ilenia Pepe, Giuseppe Licata, Luigi Calvo, Maria Valenti, Claudio Borghi, Enrico Strocchi, Elisa Rebecca Rinaldi, Marco Zoli, Elisa Fabbri, Donatella Magalotti, Alberto Auteri, Anna Laura Pasqui, Luca Puccetti, Franco Laghi Pasini, Pier Leopoldo Capecchi, Maurizio Bicchi, Carlo Sabbà, Francesco Saverio Vella, Alessandro Marseglia, Chiara Valentina Luglio, Giuseppe Palasciano, Maria Ester Modeo, Annamaria Aquilino, Pallante Raffaele, Stefania Pugliese, Caterina Capobianco, Alfredo Postiglione, Maria Rosaria Barbella, Francesco De Stefano, Luigi Fenoglio, Chiara Brignone, Christian Bracco, Alessia Giraudo, Giuseppe Musca, Olga Cuccurullo, Luigi Cricco, Alessandra Fiorentini, Maria Domenica Cappellini, Giovanna Fabio, Sonia Seghezzi, Margherita Migone De Amicis, Silvia Fargion, Paola Bonara, Mara Bulgheroni, Rosa Lombardi, Fabio Magrini, Ferdinando Massari, Tatiana Tonella, Flora Peyvandi, Alberto Tedeschi, Raffaella Rossio, Guido Moreo, Barbara Ferrari, Luisa Roncari, Valter Monzani, Valeria Savojardo, Christian Folli, Maria Magnini, Daniela Mari, Paolo Dionigi Rossi, Sarah Damanti, Silvia Prolo, Maria Sole Lilleri, Giuliana Micale, Mauro Podda, Carlo Selmi, Francesca Meda, Silvia Accordino, Alessio Conca, Valentina Monti, Gino Roberto Corazza, Emanuela Miceli, Marco Vincenzo Lenti, Donatella Padula, Carlo L. Balduini, Giampiera Bertolino, Stella Provini, Federica Quaglia, Giovanni Murialdo, Marta Bovio, Franco Dallegri, Luciano Ottonello, Alessandra Quercioli, Alessandra Barreca, Maria Beatrice Secchi, Davide Ghelfi, Wu Sheng Chin, Laura Carassale, Silvia Caporotundo, Luigi Anastasio, Lucia Sofia, Maria Carbone, Giancarlo Traisci, Lucrezia De Feudis, Silvia Di Carlo, Giovanni Daví, Maria Teresa Guagnano, Simona Sestili, Elisabetta Bergami, Emanuela Rizzioli, Carlo Cagnoni, Luca Bertone, Antonio Manucra, Alberto Buratti, Tiziana Tognin, Nicola Lucio Liberato, Giordano Bernasconi, Barbara Nardo, Giovanni Battista Bianchi, Giampiero Benetti, Michela Quagliolo, Giuseppe Riccardo Centenaro, Francesco Purrello, Antonino Di Pino, Salvatore Piro, Gerardo Mancuso, Daniela Calipari, Mosè Bartone, Francesco Gullo, Michele Cortellaro, Marina Magenta, Francesca Perego, Maria Rachele Meroni, Marco Cicardi, Antonio Gidaro Marina Magenta, Andrea Sacco, Antonio Bonelli, Gaetano Dentamaro, Renzo Rozzini, Lina Falanga, Alessandro Giordano, Paolo Cavallo Perin, Bartolomeo Lorenzati, Gabriella Gruden, Graziella Bruno, Giuseppe Montrucchio, Elisabetta Greco, Pietro Tizzani, Giacomo Fera, Maria Loreta Di Luca, Donatella Renna, Antonio Perciccante, Alessia Coralli, Rodolfo Tassara, Deborah Melis, Lara Rebella, Giorgio Menardo, Stefania Bottone, Elsa Sferrazzo, Claudio Ferri, Rinaldo Striuli, Rosa Scipioni, Raffaella Salmi, Piergiorgio Gaudenzi, Susanna Gamberini, Franco Ricci, Cosimo Morabito, Roberto Fava, Andrea Semplicini, Lucia Gottardo, Gianluigi Vendemiale, Gaetano Serviddio, Roberta Forlano, Luigi Bolondi, Leonardo Rasciti, Ilaria Serio, Cesare Masala, Antonio Mammarella, Valeria Raparelli, Filippo Rossi Fanelli, Massimo Delfino, Antonio Amoroso, Francesco Violi, Stefania Basili, Ludovica Perri, Pietro Serra, Vincenzo Fontana, Marco Falcone, Raffaele Landolfi, Antonio Grieco, Antonella Gallo, Giuseppe Zuccalà, Francesco Franceschi, Guido De Marco, Cordischi Chiara, Sabbatini Marta, Martino Bellusci, Donatella Setti, Filippo Pedrazzoli, Giuseppe Romanelli, Caterina Pirali, Claudia Amolini, Enrico Agabiti Rosei, Damiano Rizzoni, Luana Castoldi, Antonio Picardi, Umberto Vespasiani Gentilucci, Chiara Mazzarelli, Paolo Gallo, Luigina Guasti, Luana Castiglioni, Andrea Maresca, Alessandro Squizzato, Sara Contini, Marta Molaro, Giorgio Annoni, Maurizio Corsi Sara Zazzetta, Marco Bertolotti, Chiara Mussi Roberto Scotto, Maria Alice Ferri, Francesca Veltri, Franco Arturi, Elena Succurro, Giorgio Sesti, Umberto Gualtieri, Francesco Perticone, Angela Sciacqua, Michele Quero, Chiara Bagnato, Paola Loria, Maria Angela Becchi, Gianfranco Martucci, Alessandra Fantuzzi, Mauro Maurantonio, Roberto Corinaldesi, Roberto De Giorgio, Mauro Serra, Valentina Grasso, Eugenio Ruggeri, Lorenzo Mauro Carozza, Fabio Pignatti

Research output: Contribution to journalArticle

16 Scopus citations

Abstract

Pharmacological thromboprophylaxis (TP) is known to reduce venous thromboembolism (VTE) in medical inpatients, but the criteria for risk-driven prescription, safety and impact on mortality are still debated. We analyze data on elderly patients with multimorbidities admitted in the year 2010 to the Italian internal medicine wards participating in the REPOSI registry to investigate the rate of TP during the hospital stay, and analyze the factors that are related to its prescription. Multivariate logistic regression, area under the ROC curve and CART analysis were performed to look for independent predictors of TP prescription. Association between TP and VTE, bleeding and death in hospital and during the 3-month postdischarge follow-up were explored by logistic regression and propensity score analysis. Among the 1,380 patients enrolled, 171 (15.2%) were on TP during the hospital stay (162 on low molecular weight heparins, 9 on fondaparinux). The disability Barthel index was the main independent predictor of TP prescription. Rate of fatal and non-fatal VTE and bleeding during and after hospitalization did not differ between TP and non-TP patients. In-hospital and post-discharge mortality was significantly higher in patients on TP, that however was not an independent predictor of mortality. Among elderly medical patients there was a relatively low rate of TP, that was more frequently prescribed to patients with a higher degree of disability and who had an overall higher mortality.

Original languageEnglish (US)
Pages (from-to)509-520
Number of pages12
JournalInternal and Emergency Medicine
Volume8
Issue number6
DOIs
StatePublished - 2013
Externally publishedYes

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Keywords

  • Medical patients
  • Thromboprophylaxis
  • Venous thromboembolism

ASJC Scopus subject areas

  • Internal Medicine
  • Emergency Medicine

Cite this

Marcucci, M., Iorio, A., Nobili, A., Tettamanti, M., Pasina, L., Djade, C. D., Marengoni, A., Salerno, F., Corrao, S., Mannucci, P. M., Franchi, C., Sparacio, E., Alborghetti, S., Di Costanzo, R., Prisco, D., Silvestri, E., Cenci, C., Barnini, T., Delitala, G., ... Pignatti, F. (2013). Prophylaxis of venous thromboembolism in elderly patients with multimorbidity. Internal and Emergency Medicine, 8(6), 509-520. https://doi.org/10.1007/s11739-013-0944-8