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Fever and deep venous thrombosis. Findings from the RIETE registry

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Abstract

Fever is a presenting sign in some patients with acute deep venous thrombosis (DVT), but its influence on outcome has not been thoroughly investigated. RIETE is an ongoing, international, observational registry of consecutive patients with symptomatic, objectively confirmed, acute venous thromboembolism. The aim of the present study was to assess the prevalence of fever in patients with acute DVT, and to compare their outcome during the first month of therapy, according to the presence or absence of fever. As of September 2009, 14,480 patients with symptomatic DVT have been enrolled in RIETE. Of these, 707 (4.9%) had fever at presentation. During the 30-day study period, 448 patients (3.1%) died, 171 (1.2%) developed DVT recurrences, 376 (2.6%) had pulmonary embolism, and 384 (2.6%) had a major bleeding. Patients initially presenting with fever had a higher mortality (5.8% vs. 2.9%; odds ratio: 2.6; 95% CI 1.9–3.5) than those without fever. Among the causes of death, pulmonary embolism (0.7% vs. 0.1%) and infection (1.1% vs. 0.3%) were significantly more common in patients presenting with fever. Multivariate analysis confirmed that DVT patients with fever had an increased mortality (hazard ratio: 2.00; 95% CI 1.44–2.77) irrespectively of the patient’s age, body weight, and risk factors for VTE. Fever is not uncommon in patients with DVT, and carries a worse outcome.

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Acknowledgments

We express our gratitude to Sanofi-Aventis Spain for supporting this Registry with an unrestricted educational grant. We also express our gratitude to Bayer Schering Pharma for supporting this Registry. Bayer Schering Pharma’s support was limited to the part of RIETE outside Spain, which accounts for a 13.49% of the total patients included in the RIETE Registry. We also thank the Registry Coordinating Center, S & H Medical Science Service, for their quality control, logistic and administrative support.

Author information

Authors and Affiliations

  1. Department of Internal Medicine, Fundación Hospital Alcorcón, c/Budapest s/n, Madrid, Spain

    Raquel Barba

  2. Department of Internal Medicine, Ospedale Buonconsiglio Fatebenefratelli, Naples, Italy

    Pierpaolo Di Micco

  3. Department of Internal Medicine, Hospital Universitario Reina Sofía, Córdoba, Spain

    Ángeles Blanco-Molina

  4. Department of Internal Medicine, Hospital Alto Gudalquivir, Andújar, Jaén, Spain

    Cristina Delgado

  5. Department of Internal Medicine, Hospital Son Llatzer, Palma de Mallorca, Spain

    Elena Cisneros

  6. Department of Internal Medicine, Hospital Clinic, Barcelona, Spain

    Jaume Villalta

  7. Department of Internal Medicine, Hospital del Tajo, Aranjuez, Madrid, Spain

    María V. Morales

  8. Department of Vascular Medicine, Hôpital de Rangueil, Toulouse, France

    Alessandra Bura-Riviere

  9. Department of Internal Medicine, Hôpital Desgenettes, Lyon, France

    Philippe Debourdeau

  10. Department of Internal Medicine, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain

    Manuel Monreal

Authors
  1. Raquel Barba
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  2. Pierpaolo Di Micco
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  3. Ángeles Blanco-Molina
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  4. Cristina Delgado
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  5. Elena Cisneros
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  6. Jaume Villalta
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  7. María V. Morales
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  8. Alessandra Bura-Riviere
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  9. Philippe Debourdeau
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  10. Manuel Monreal
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Corresponding author

Correspondence to Raquel Barba.

Additional information

This study is conducted for the RIETE investigators. A full list of RIETE investigators is given in the Appendix.

Appendix

Appendix

Coordinator of the RIETE Registry

Dr. Manuel Monreal (Spain)

RIETE Steering Committee Members

Dr. Hervè Decousus (France)

Dr. Paolo Prandoni (Italy)

Dr. Benjamin Brenner (Israel)

RIETE National Coordinators

Dr. Raquel Barba (Spain)

Dr. Pierpaolo Di Micco (Italy)

Dr. Laurent Bertoletti (France)

Dr. Manolis Papadakis (Greece)

Dr. Marijan Bosevski (R. Macedonia)

Dr. Henri Bounameaux (Switzerland)

RIETE Registry Coordinating Center

S & H Medical Science Service

Members of the RIETE group

SPAIN: Arcelus JI, Arcos MP, Barba R, Barrón M, Blanco-Molina A, Bosco J, Boix L, Cámara T, Casado I, Casas JM, Cisneros E, Chaves E, Conget F, del Campo R. Delgado C, del Toro J, Durán M, Falgá C, Fernández-Capitán C, Ferreiro M, Font C, Gabriel F, Gallego P, García-Bragado F, Guil M, Gutiérrez J, Hernández L, Hernández-Huerta D, Hernández-Toboso F, Jaras MJ, Jiménez D, Jiménez S, Jiménez P, Jiménez-Gil M, Lecumberri R, Lobo JL, López-Jiménez L, Lorenzo A, Luque JM, Lladó M, Madridano O, Maestre A, Marchena PJ, Martín-Villasclaras JJ, Monreal M, Montes J, Morales M, Muñoz S, Nauffal MD, Nieto JA, Ogea JL, Oribe M, Otero R, Pedrajas JM, Rabuñal R, Riera-Mestre A, Roldán V, Rodríguez-Dávila MA, Román P, Román-Bernal B, Rosa V, Royo C, Rubio S, Ruíz J, Ruiz-Gamietea A, Ruiz-Giménez N, Sahuquillo JC, Samperiz A, Sánchez R, Sánchez Muñoz-Torrero JF, Soler S, Soto MJ, Tiberio G, Tolodí JA, Tolosa C, Torres MI, Trujillo J, Uresandi F, Valdés M, Valdés V, Valle R, Vidal G, Villalta J. Zorrilla V. FRANCE : Bertoletti L, Bura-Riviere A, Debourdeau P, Mahe I, Rivron-Guillot K, GREECE: Papadakis, M, Babalis D, Tzinieris I. ISRAEL: Brenner B ITALY: Barillari A, Barillari G, Ciammaichella M, Di Micco P, Dalla Valle F, Duce R, Maida R, Pasca S, Piovella C, Poggio R, Prandoni P, Quintavalla R, Schenone A, Tiraferri E, Visonà A, REPUBLIC OF MACEDONIA: Bosevski M. SWITZERLAND: Bounameaux H,

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Barba, R., Di Micco, P., Blanco-Molina, Á. et al. Fever and deep venous thrombosis. Findings from the RIETE registry. J Thromb Thrombolysis 32, 288–292 (2011). https://doi.org/10.1007/s11239-011-0604-7

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