Analysis of clinical relevant bleeding events in the elderly patients with acute pulmonary thromboembolism after treatment

Abstract

To investigate the incidences of clinical relevant bleeding events and risk factors in elderly patients with acute pulmonary thromboembolism (PTE). Between January of 2009 and December of 2013, a total of 539 initially diagnosed PTE patients were recruited in our study in Beijing Chao Yang hospital. Basic clinical characteristics, medical history, imaging results, laboratory tests, therapy and outcomes (including mortality, recurrence and incidences of bleeding events) were collected during 3 months' follow-up. All the patients were divided into two groups according to age (≤ 65 years and >65 years ), and these parameters were compared between the two groups. Compared with younger patients (≤ 65 years old), older patients (>65 years) had higher incidences of total bleeding, clinical relevant non-major bleeding (20.2% vs 13.4%, P=0.038; 16.7% vs 10.5%, P=0.043). The incidence of gastrointestinal bleeding of the elderly was also higher than that of younger patients (6.0% vs 1.4%, P=0.005) and majority of bleeding events were within 1 month after initial treatment. For the elderly, chronic liver diseases (P=0.001, OR=9.229), ischemic stroke (P=0.001, OR=6.323) and anemia (P=0.014, OR=3.774) were independent risk factors for major bleeding, and malignancy (P<0.001, OR=3.140) was independent risk factor for clinical relevant non-major bleeding. The independent risk factors for gastrointestinal bleeding were diabetes mellitus (P=0.012, OR=3.711) and anemia (P<0.001, OR=5.863). The older PTE patients had higher incidences of total bleeding and clinical relevant non-major bleeding. Gastrointestinal bleeding of the elderly was also higher than that of younger patients and mainly occurred within 1 month after initial treatment. Complications can increase the risk of bleeding in older PTE patients.