Anticoagulant Therapy Is Associated With Decreased Long-Term Mortality in Splenic Infarction Patients: A Multicenter Study

Background: Patients with splenic infarction (SI) are associated with a prothrombotic state and are vulnerable to subsequent thromboembolic complications. However, due to its rarity, there is no established treatment modality in this population. We aimed to examine the effect of anticoagulant therap...

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Autores principales:	Chieh-Ching Yen, Chih-Kai Wang, Chung-Hsien Chaou, Shou-Yen Chen, Jhe-Ping Lin, Chip-Jin Ng
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	anticoagulant splenic infarction mortality outcome treatment Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/e7938cacde6846ebbc259a36b63af3b9
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spelling	oai:doaj.org-article:e7938cacde6846ebbc259a36b63af3b92021-12-01T12:50:15ZAnticoagulant Therapy Is Associated With Decreased Long-Term Mortality in Splenic Infarction Patients: A Multicenter Study2296-858X10.3389/fmed.2021.778198https://doaj.org/article/e7938cacde6846ebbc259a36b63af3b92021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fmed.2021.778198/fullhttps://doaj.org/toc/2296-858XBackground: Patients with splenic infarction (SI) are associated with a prothrombotic state and are vulnerable to subsequent thromboembolic complications. However, due to its rarity, there is no established treatment modality in this population. We aimed to examine the effect of anticoagulant therapy in SI patients.Methods: We performed a multicenter retrospective cohort study of 86 SI patients. Patients were categorized as anticoagulant users and anticoagulant non-users. The associations between anticoagulant therapy, all-cause mortality, thromboembolic events and bleeding events were evaluated.Results: Forty-five patients (52.3%) received anticoagulant therapy during the follow-up periods. The all-cause mortality rate was 6.86 per 100 patient-years. Anticoagulant therapy was associated with 94% improved survival (HR = 0.06; Cl 0.007–0.48; p = 0.008), while the risk factors for all-cause mortality were prior stroke (HR = 13.15; Cl 2.39–72.27; p = 0.003) and liver cirrhosis (HR = 8.71; Cl 1.29–59.01; p = 0.027). Patients with anticoagulant therapy had a higher event-free survival curve for thromboembolic complications (p = 0.03) but did not achieve a significant difference after adjustment using the Cox regression model as a time-dependent covariate (HR = 0.57; Cl 0.13–2.45; p = 0.446). There was no significant difference in the risk of bleeding events between the groups (p = 0.728).Conclusions: Anticoagulant therapy in patients with SI was associated with better survival and was not related to an increased bleeding risk.Chieh-Ching YenChieh-Ching YenChih-Kai WangChih-Kai WangChung-Hsien ChaouChung-Hsien ChaouChung-Hsien ChaouShou-Yen ChenShou-Yen ChenShou-Yen ChenJhe-Ping LinJhe-Ping LinChip-Jin NgChip-Jin NgFrontiers Media S.A.articleanticoagulantsplenic infarctionmortalityoutcometreatmentMedicine (General)R5-920ENFrontiers in Medicine, Vol 8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	anticoagulant splenic infarction mortality outcome treatment Medicine (General) R5-920
spellingShingle	anticoagulant splenic infarction mortality outcome treatment Medicine (General) R5-920 Chieh-Ching Yen Chieh-Ching Yen Chih-Kai Wang Chih-Kai Wang Chung-Hsien Chaou Chung-Hsien Chaou Chung-Hsien Chaou Shou-Yen Chen Shou-Yen Chen Shou-Yen Chen Jhe-Ping Lin Jhe-Ping Lin Chip-Jin Ng Chip-Jin Ng Anticoagulant Therapy Is Associated With Decreased Long-Term Mortality in Splenic Infarction Patients: A Multicenter Study
description	Background: Patients with splenic infarction (SI) are associated with a prothrombotic state and are vulnerable to subsequent thromboembolic complications. However, due to its rarity, there is no established treatment modality in this population. We aimed to examine the effect of anticoagulant therapy in SI patients.Methods: We performed a multicenter retrospective cohort study of 86 SI patients. Patients were categorized as anticoagulant users and anticoagulant non-users. The associations between anticoagulant therapy, all-cause mortality, thromboembolic events and bleeding events were evaluated.Results: Forty-five patients (52.3%) received anticoagulant therapy during the follow-up periods. The all-cause mortality rate was 6.86 per 100 patient-years. Anticoagulant therapy was associated with 94% improved survival (HR = 0.06; Cl 0.007–0.48; p = 0.008), while the risk factors for all-cause mortality were prior stroke (HR = 13.15; Cl 2.39–72.27; p = 0.003) and liver cirrhosis (HR = 8.71; Cl 1.29–59.01; p = 0.027). Patients with anticoagulant therapy had a higher event-free survival curve for thromboembolic complications (p = 0.03) but did not achieve a significant difference after adjustment using the Cox regression model as a time-dependent covariate (HR = 0.57; Cl 0.13–2.45; p = 0.446). There was no significant difference in the risk of bleeding events between the groups (p = 0.728).Conclusions: Anticoagulant therapy in patients with SI was associated with better survival and was not related to an increased bleeding risk.
format	article
author	Chieh-Ching Yen Chieh-Ching Yen Chih-Kai Wang Chih-Kai Wang Chung-Hsien Chaou Chung-Hsien Chaou Chung-Hsien Chaou Shou-Yen Chen Shou-Yen Chen Shou-Yen Chen Jhe-Ping Lin Jhe-Ping Lin Chip-Jin Ng Chip-Jin Ng
author_facet	Chieh-Ching Yen Chieh-Ching Yen Chih-Kai Wang Chih-Kai Wang Chung-Hsien Chaou Chung-Hsien Chaou Chung-Hsien Chaou Shou-Yen Chen Shou-Yen Chen Shou-Yen Chen Jhe-Ping Lin Jhe-Ping Lin Chip-Jin Ng Chip-Jin Ng
author_sort	Chieh-Ching Yen
title	Anticoagulant Therapy Is Associated With Decreased Long-Term Mortality in Splenic Infarction Patients: A Multicenter Study
title_short	Anticoagulant Therapy Is Associated With Decreased Long-Term Mortality in Splenic Infarction Patients: A Multicenter Study
title_full	Anticoagulant Therapy Is Associated With Decreased Long-Term Mortality in Splenic Infarction Patients: A Multicenter Study
title_fullStr	Anticoagulant Therapy Is Associated With Decreased Long-Term Mortality in Splenic Infarction Patients: A Multicenter Study
title_full_unstemmed	Anticoagulant Therapy Is Associated With Decreased Long-Term Mortality in Splenic Infarction Patients: A Multicenter Study
title_sort	anticoagulant therapy is associated with decreased long-term mortality in splenic infarction patients: a multicenter study
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/e7938cacde6846ebbc259a36b63af3b9
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Anticoagulant Therapy Is Associated With Decreased Long-Term Mortality in Splenic Infarction Patients: A Multicenter Study

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