Sex differences in utilization and outcomes of catheter-directed thrombolysis in patients with proximal lower extremity deep venous thrombosis - Insights from the Nationwide Inpatient Sample

Vladimir Lakhter, Chad J. Zack, Yevgeniy Brailovsky, Saurav Chatterjee, Vikas Aggarwal, Koneti A. Rao, Deborah Crabbe, Huaqing Zhao, Eric Choi, Raghu Kolluri, Riyaz Bashir

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Catheter-directed thrombolysis (CDT) is being increasingly used for the treatment of proximal lower extremity (LE) deep venous thrombosis (DVT). However, sex differences in utilization and safety outcomes of CDT in these patients are unknown. The Nationwide Inpatient Sample (NIS) database was used to identify all patients with a principal discharge diagnosis of proximal LE or caval DVT who underwent CDT between January 2005 and December 2011 in the United States. We evaluated the comparative safety outcomes of CDT among a propensity-matched group of 1731 men versus 1731 women. Among 108,243 patients with proximal LE or caval DVT, 4826 patients (4.5%) underwent CDT. Overall, women underwent CDT less often compared to men (4.1% vs 4.9%, p<0.01, respectively). The rates of CDT increased between 2005 and 2011 for both women (2.1% to 5.9%, p<0.01) and men (2.5% to 7.5%, p<0.01). There was no significant difference in in-hospital mortality (1.2% vs 1.3%, p=0.76). Women were noted to have higher rates of blood transfusions (11.7% vs 8.8%, p<0.01), but lower rates of intracranial hemorrhage (0.5% vs 1.2%, p=0.03) and gastrointestinal bleeding (0.9% vs 2.2%, p<0.01) compared with men. Women were more likely to undergo inferior vena cava filter placement (37.0% vs 32.1%, p<0.01). In this large nationwide cohort, women with proximal DVT were less likely to receive CDT compared to men. Although mortality rates were similar, women were noted to have higher blood transfusion rates while men had more episodes of intracranial and gastrointestinal bleeding.

Original languageEnglish (US)
Pages (from-to)128-134
Number of pages7
JournalVascular Medicine (United Kingdom)
Volume22
Issue number2
DOIs
StatePublished - Apr 1 2017

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Venous Thrombosis
Sex Characteristics
Inpatients
Lower Extremity
Catheters
Venae Cavae
Blood Transfusion
Hemorrhage
Vena Cava Filters
Safety
Intracranial Hemorrhages
Hospital Mortality
Research Design
Databases
Mortality

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Lakhter, Vladimir ; Zack, Chad J. ; Brailovsky, Yevgeniy ; Chatterjee, Saurav ; Aggarwal, Vikas ; Rao, Koneti A. ; Crabbe, Deborah ; Zhao, Huaqing ; Choi, Eric ; Kolluri, Raghu ; Bashir, Riyaz. / Sex differences in utilization and outcomes of catheter-directed thrombolysis in patients with proximal lower extremity deep venous thrombosis - Insights from the Nationwide Inpatient Sample. In: Vascular Medicine (United Kingdom). 2017 ; Vol. 22, No. 2. pp. 128-134.
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abstract = "Catheter-directed thrombolysis (CDT) is being increasingly used for the treatment of proximal lower extremity (LE) deep venous thrombosis (DVT). However, sex differences in utilization and safety outcomes of CDT in these patients are unknown. The Nationwide Inpatient Sample (NIS) database was used to identify all patients with a principal discharge diagnosis of proximal LE or caval DVT who underwent CDT between January 2005 and December 2011 in the United States. We evaluated the comparative safety outcomes of CDT among a propensity-matched group of 1731 men versus 1731 women. Among 108,243 patients with proximal LE or caval DVT, 4826 patients (4.5{\%}) underwent CDT. Overall, women underwent CDT less often compared to men (4.1{\%} vs 4.9{\%}, p<0.01, respectively). The rates of CDT increased between 2005 and 2011 for both women (2.1{\%} to 5.9{\%}, p<0.01) and men (2.5{\%} to 7.5{\%}, p<0.01). There was no significant difference in in-hospital mortality (1.2{\%} vs 1.3{\%}, p=0.76). Women were noted to have higher rates of blood transfusions (11.7{\%} vs 8.8{\%}, p<0.01), but lower rates of intracranial hemorrhage (0.5{\%} vs 1.2{\%}, p=0.03) and gastrointestinal bleeding (0.9{\%} vs 2.2{\%}, p<0.01) compared with men. Women were more likely to undergo inferior vena cava filter placement (37.0{\%} vs 32.1{\%}, p<0.01). In this large nationwide cohort, women with proximal DVT were less likely to receive CDT compared to men. Although mortality rates were similar, women were noted to have higher blood transfusion rates while men had more episodes of intracranial and gastrointestinal bleeding.",
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Sex differences in utilization and outcomes of catheter-directed thrombolysis in patients with proximal lower extremity deep venous thrombosis - Insights from the Nationwide Inpatient Sample. / Lakhter, Vladimir; Zack, Chad J.; Brailovsky, Yevgeniy; Chatterjee, Saurav; Aggarwal, Vikas; Rao, Koneti A.; Crabbe, Deborah; Zhao, Huaqing; Choi, Eric; Kolluri, Raghu; Bashir, Riyaz.

In: Vascular Medicine (United Kingdom), Vol. 22, No. 2, 01.04.2017, p. 128-134.

Research output: Contribution to journalArticle

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T1 - Sex differences in utilization and outcomes of catheter-directed thrombolysis in patients with proximal lower extremity deep venous thrombosis - Insights from the Nationwide Inpatient Sample

AU - Lakhter, Vladimir

AU - Zack, Chad J.

AU - Brailovsky, Yevgeniy

AU - Chatterjee, Saurav

AU - Aggarwal, Vikas

AU - Rao, Koneti A.

AU - Crabbe, Deborah

AU - Zhao, Huaqing

AU - Choi, Eric

AU - Kolluri, Raghu

AU - Bashir, Riyaz

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Y1 - 2017/4/1

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