• Fahd Beddar Chaib, Sònia Jiménez Hernández, José María Pedrajas Navas, Ramón Lecumberri, Leticia Guirado Torrecillas, Héctor Alonso Valle, Susana Diego Roza, Vanesa Sendín Martín, Mª Angélica Rivera Núñez, Jorge Pedraza García, Daniel Sánchez Díaz-Canel, Pedro Ruiz Artacho, and Grupo de Enfermedad Tromboembólica Venosa de la Sociedad Española de Medicina de Urgencias y Emergencias (ETV-SEMES).
• Servicio de Urgencias, Complejo Asistencial de Soria, Soria, España. Universidad de Valladolid, Facultad de Ciencias de la Salud, Valladolid, España.
• Emergencias. 2023 Apr 1; 35 (2): 109116109-116.

ObjectivesTo describe the management of superficial vein thrombosis (SVT) of the lower limbs in patients treated in Spanish hospital emergency departments (EDs). To evaluate the impact of ED management of venous thromboembolic complications on outcomes and to determine the characteristics of patients who develop complications.Material And MethodsThe retrospective multicenter ALTAMIRA study (Spanish acronym for risk factors, complications, and assessment of Spanish ED management of SVT) used recorded data for consecutive patients with a diagnosis of isolated SVT treated in 18 EDs. We gathered data on symptomatic venous thromboembolic disease (deep vein thrombosis, pulmonary embolism, or the extension or recurrence of SVT), clinically significant bleeding, and 180-day mortality. Cox regression analysis was used to explore variables associated with complications.ResultsA total of 703 patients were included. Anticoagulation was prescribed for 84.1% of the patients for a median of 30 days (interquartile range, 15-42 days); 81.3% were treated with low molecular weight heparin. A prophylactic dose was prescribed for 48% and an intermediate therapeutic dose for 52%. Sixty-four patients (9.2%) developed symptomatic thromboembolic disease within 180 days, 12 (1.7%) experienced clinically significant bleeding, and 4 (0.6%) died. Complications developed later in patients receiving anticoagulant therapy than in those not taking an anticoagulant (66 vs 11 days , P=.009), and 76.6% of those developing complications were not on anticoagulant when symptoms appeared. A history of thromboembolic disease was associated with developing complications (adjusted hazard ratio, 2.20; 95% confidence interval, 1.34-3.62).ConclusionED treatment of SVT varies and is often suboptimal. The incidence of thromboembolic complications after SVT is high. Starting anticoagulation in the ED delays the development of complications. Patients with a history of thromboembolic disease are more at risk of complications.

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