Factors affecting recurrence and bleeding complications in patients withvenous thromboembolism

Introduction: Risk of recurrence and bleeding, play a role in considering the optimal duration of treatment. The aim of the study was to determine the frequency of recurrence, risk factors for recurrence and bleeding in cases with VTE. Material-methods:: Study included 412 VTE patients (164 male, 248 female, mean age: 53.5years, follow-up period: 25.3months). Patient9s demographics, risk factors, comorbidities, clinical data, treatment and complications were recorded. Results: There was at least one risk factor in 341 (82.7%) patients and 71 (17.2%) of them were idiopathic. In 76 (18.4%) of the cases VTE recurrence developed. There was no difference between recurrent and non-recurrent groups according to age and sex. There was no relationship between recurrence and mortality. Recurrence was higher in DVT and / or PTE+DVT groups than PTE group (24% vs 14.2%, p=0.007). Idiopathic VTE was higher in recurrent cases (26.3% vs 15.2%, p=0.028). D-dimer levels were higher in recurrent cases at first year control (p=0.034). Hereditary risk factors were higher in recurrent cases (p=0.031). During VTE treatment, 37 (8.9%) of cases had bleeding however major bleeding rate was 3.6%. Duration of anticoagulant was longer in patients who had bleeding (22months vs 12months p=0.047). Bleeding rate was higher in patients with massive PTE (p=0.001) and in elderly patients (≥75years) (p=0.036). Conclusion: In our study, presence of DVT, idiopathic VTE, hereditary risk factors and high D-dimer levels at first year were found as related factors of recurrence. Risk of bleeding increased in recurrent cases, in elderly cases and in cases whose treatment duration was longer in the first VTE event.