Introduction
Materials and Methods
Study Design and Setting
Selection of Participants
Definitions
Intervention
Outcome Assessment
Analysis
Results
Characteristics of Study Subjects
n (% of 33) | |
---|---|
Demographic data
| |
Age (median years (IQR)) | 63 (51–71) |
Female (%) | 17 (52) |
Patient related factors
| |
History of VTE | 8 (25)a |
Active malignancy | 8 (24) |
Therapeutic anticoagulation (VKA, DOAC) | 2 (6) |
Clinical status
| |
Hypotension (SBP < 100 mmHg) | 18 (62)b |
Shock | 31 (93)a |
RV dysfunction | 30 (97)c |
Resuscitation | 20 (61) |
Mechanical ventilation | 16 (49)a |
Major bleeding risk factors | |
1 risk factor | 13 (39) |
2 or more risk factors | 1 (3) |
Minor bleeding risk factors | |
1 risk factor | 6 (18) |
2 or more risk factors | 1 (3) |
Indication for USAT
| |
Contraindications for ST | 23 (70) |
Insufficient clinical improvement after ST | 6 (18) |
Unknown | 4 (12) |
Outcomes
n (% of 33) | 95% CI | |
---|---|---|
Primary outcomes (after 1 month) | ||
Major bleeding | 12 (36) | 22–53 |
All-cause mortality | 16 (49) | 31–66 |
Secondary outcomes (after 3 months) | ||
All-cause mortality | 16 (50)a | 34–66 |
Recurrence of VTE | 1 (3)a | 1–16 |
Other outcomes
| ||
Hospital length of stay (median days (IQR)) | 17 (10–30)b |
Major bleeding (as defined by the ISTH23) |
n
|
---|---|
Access site hematoma | 4 |
Intrathoracic bleeding (hemothorax or chest wall after traumatic resuscitation or surgery) | 4 |
Intraabdominal hematoma | 3 |
Mucosal bleeding (nasal) | 2 |
Bleeding from ECMO cannula site | 1 |
Hematoma on lower arm, causing compartment syndrome | 1 |
Hemorrhagic transformation of ischemic stroke | 1 |
Total number of major bleeding episodes in 12 patients with major bleeding | 16 |
USAT and Additional Therapies
Patient | ST | Thrombus aspiration | VCF | ECMO | Major bleeding | Mortality |
---|---|---|---|---|---|---|
1 | Full dose | – | Yes | – | – | Yes |
2 | – | Yes | Yes | – | – | – |
3 | Full dose | Yes | – | Yes | – | Yes |
4 | Low dose | Yes | – | – | Yes | Yes |
5 | Loading dose | Yes | – | – | – | Yes |
6 | Full dose | Yes | – | – | Yes | – |
7 | – | Yes | – | Yes | – | – |
8 | – | Yes | – | – | Yes | – |
9 | – | Yes | – | – | – | – |
10 | Lower dose | – | – | – | – | Yes |
11 | Lower dose | – | – | – | – | Yes |
12 | Lower dose | – | – | Yes | – | – |
13 | Lower dose | – | – | – | – | – |
14 | Full dose | – | – | Yes | Yes | Yes |
Total | 10 | 8 | 2 | 4 |