Predictors of in-hospital mortality in elderly patients with acute venous thrombo-embolism: the SWIss Venous ThromboEmbolism Registry (SWIVTER)

Although acute venous thrombo-embolism (VTE) often afflicts patients with advanced age, the predictors of in-hospital mortality for elderly VTE patients are unknown. Among 1247 consecutive patients with acute VTE from the prospective SWIss Venous ThromboEmbolism Registry (SWIVTER), 644 (52) were elderly (epsilon 65 years of age). In comparison to younger patients, the elderly more often had pulmonary embolism (PE) (60 vs. 42; P 0.001), cancer (30 vs. 20; P 0.001), chronic lung disease (14 vs. 8; P 0.001), and congestive heart failure (12 vs. 2; P 0.001). Elderly VTE patients were more often hospitalized (75 vs. 52; P 0.001), and there was no difference in the use of thrombolysis, catheter intervention, or surgical embolectomy between the elderly and younger PE patients (5 vs. 6; P 0.54), despite a trend towards a higher rate of massive PE in the elderly (8 vs. 4; P 0.07). The overall in-hospital mortality rate was 6.6 in the elderly vs. 3.2 in the younger VTE patients (P 0.033). Cancer was associated with in-hospital death both in the elderly [hazard ratio (HR) 4.91, 95 confidence interval (CI) 2.3210.38; P 0.001] and in the younger patients (HR 4.90, 95 CI 1.3717.59; P 0.015); massive PE was a predictor of in-hospital death in the elderly only (HR 3.77, 95 CI 1.638.74; P 0.002). Elderly patients had more serious VTE than younger patients, and massive PE was particularly life-threatening in the elderly.