Jørgen B Vennesland1, Kjetil Søreide2,3,4, Jan Terje Kvaløy5,6, Andreas Reite7, Morten Vetrhus7. 1. Department of Surgery, Vascular Surgery Unit, Stavanger University Hospital, PO Box 8100, 4068, Stavanger, Norway. Jorgen.bendik.vennesland@sus.no. 2. Department of Gastrointestinal Surgery, Stavanger University Hospital, Stavanger, Norway. 3. University of Bergen, Bergen, Norway. 4. Clinical Medicine, University of Bergen, Bergen, Norway. 5. Research Department, Stavanger University Hospital, Stavanger, Norway. 6. Department of Mathematics and Physics, University of Stavanger, Stavanger, Norway. 7. Department of Surgery, Vascular Surgery Unit, Stavanger University Hospital, PO Box 8100, 4068, Stavanger, Norway.
Abstract
OBJECTIVES: To investigate the epidemiology of acute upper limb thromboembolism in a well-defined Norwegian population. METHODS: This study was a retrospective, single-center, observational population-based cohort study of acute upper limb thromboembolism. The study included all patients from the hospital's primary catchment area from January 2000 to December 2015. Age- and gender-adjusted incidence rates were calculated using population demographics from Statistics Norway. RESULTS: A total of 54 patients were identified, of which 49 were included in the analyses: 27 (55%) females (median age 83 years, range 40-96) and 22 (45%) males (median age 70 years, range 42-95) (P = .053). The adjusted incidence rate for the period was 1.6 patients per 100,000 inhabitants per year (95% confidence interval 1.2-2.2) and did not change significantly during the period studied. Atrial fibrillation was detected by electrocardiography in 30 (61%) patients; in this group, 10 patients were on warfarin but only two had an international normalized ratio > 1.9 and the remaining 20 were not anticoagulated. Altogether, 38 (78%) patients underwent surgery, 1 (2%) was treated with thrombolysis, and the remaining patients were treated conservatively; no amputations were performed. Four patients (8%) died within 30 days, and 12 of the surviving 45 patients (27%) had recurrent thromboembolism. CONCLUSION: The incidence rate was stable during the study period. Patients with upper limb thromboembolism due to atrial fibrillation were inadequately anticoagulated. One in four patients experienced a recurrent thromboembolic event. Lifelong anticoagulation should be considered in all patients with upper limb thromboembolism.
OBJECTIVES: To investigate the epidemiology of acute upper limb thromboembolism in a well-defined Norwegian population. METHODS: This study was a retrospective, single-center, observational population-based cohort study of acute upper limb thromboembolism. The study included all patients from the hospital's primary catchment area from January 2000 to December 2015. Age- and gender-adjusted incidence rates were calculated using population demographics from Statistics Norway. RESULTS: A total of 54 patients were identified, of which 49 were included in the analyses: 27 (55%) females (median age 83 years, range 40-96) and 22 (45%) males (median age 70 years, range 42-95) (P = .053). The adjusted incidence rate for the period was 1.6 patients per 100,000 inhabitants per year (95% confidence interval 1.2-2.2) and did not change significantly during the period studied. Atrial fibrillation was detected by electrocardiography in 30 (61%) patients; in this group, 10 patients were on warfarin but only two had an international normalized ratio > 1.9 and the remaining 20 were not anticoagulated. Altogether, 38 (78%) patients underwent surgery, 1 (2%) was treated with thrombolysis, and the remaining patients were treated conservatively; no amputations were performed. Four patients (8%) died within 30 days, and 12 of the surviving 45 patients (27%) had recurrent thromboembolism. CONCLUSION: The incidence rate was stable during the study period. Patients with upper limb thromboembolism due to atrial fibrillation were inadequately anticoagulated. One in four patients experienced a recurrent thromboembolic event. Lifelong anticoagulation should be considered in all patients with upper limb thromboembolism.
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