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The swiss venous thromboembolism cohort 65+ (SWITCO-65+)

English title The swiss venous thromboembolism cohort 65+ (SWITCO-65+)
Applicant Aujesky Drahomir
Number 122659
Funding scheme Cohort Studies Large
Research institution Klinik und Poliklinik für Allgemeine Innere Medizin Inselspital
Institution of higher education University of Lausanne - LA
Main discipline Internal Medicine
Start/End 01.04.2009 - 31.03.2012
Approved amount 2'800'000.00
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All Disciplines (2)

Discipline
Internal Medicine
Methods of Epidemiology and Preventive Medicine

Keywords (11)

venous thromboembolism; processes of care; thrombophilia; outcomes; anticoagulation; deep vein thrombosis; cohort study; pulmonary embolism; elderly population; medical outcomes; quality of life

Lay Summary (English)

Lead
Lay summary
Venous thromboembolism (VTE) is common and has a high impact on morbidity, mortality, and costs of care. Sixty-four percent of cases with VTE are aged 65 years or more, making VTE essentially a disease of the elderly. Despite the significant public health impact of VTE in the elderly and the fact that VTE may have a less favourable course in elderly patients, older patients are underrepresented in randomized and nonrandomized prospective studies of VTE, and little is known about the factors that determine medical outcomes, quality of life, and costs of care in the elderly. The few existing prospective VTE cohort studies are limited by the enrolment of patients from highly specialized anticoagulation clinics, thrombosis centers, or single university hospitals, the explicit exclusion of elderly patients, a limited follow-up duration, or the lack of inclusion of quality of life or cost measures.The broad objective of this multicenter, interdisciplinary prospective cohort study is to determine the predictors of clinically relevant medical outcomes, health-related quality of life, and costs of care among elderly patients with VTE. The specific aims of this project are:1.To determine the association between patient factors, processes of care, and VTE recurrence following acute VTE.2.To determine the association between patient factors, processes of care, and other medical outcomes (major bleeding, overall mortality, postthrombotic syndrome, chronic thromboembolic pulmonary hypertension) following acute VTE.3.To assess what factors drive generic and disease specific health-related quality of life following acute VTE.4.To assess what factors drive costs of care following acute VTE.993 consecutive inpatients and outpatients aged 65 years or more with a diagnosis of VTE will be prospectively enrolled at 8 Swiss university and non-university hospitals and followed for up to 4 years. Because we will include consecutive patients VTE from inpatient and outpatient services at both university and non-university hospitals, the generalizability of our study results will be high. Because outpatient anticoagulant treatment will be managed by primary care physicians rather than by specialized anticoagulation clinics, our cohort study will provide a real-world picture of VTE-related processes and outcomes of care. The primary outcome will be the rate of recurrent VTE. Secondary outcomes will be major bleeding, overall mortality, and the development of the postthrombotic syndrome and chronic thromboembolic pulmonary hypertension. We will also assess generic and disease-specific quality of life and costs of care during follow-up.Our cohort addresses an important gap of knowledge, namely the impact of VTE in the rapidly growing elderly population. Successful completion of this project will provide important insight in factors that drive medical outcomes, health-related quality of life, and costs of care among elderly patients with VTE. Our findings will have value to medical providers who are committed to optimizing patient outcomes and providing high-quality, cost-effective care.
Direct link to Lay Summary Last update: 21.02.2013

Responsible applicant and co-applicants

Employees

Associated projects

Number Title Start Funding scheme
173127 Gas6 and protein S pathways in hemostasis, thrombosis and inflammation 01.09.2017 Project funding (special)
139470 The Swiss Venous Thromboembolism Cohort 65+ (SWITCO-65+) 01.04.2012 Cohort Studies Large
145014 Acquisition of a QuantStudio 12K Flex Real-Time PCR System from Applied Biosystems for the Infectious Diseases Genotyping Platform 01.06.2013 R'EQUIP
153436 Gas6 and protein S pathways in hemostasis, thrombosis and inflammation 01.09.2014 Project funding (Div. I-III)

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