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Papers by david jimenez

Research paper thumbnail of Sex-differences in the effect of obstructive sleep apnea on patients hospitalized with pulmonary embolism and on in-hospital mortality

Scientific Reports, 2021

We determined sex differences in the prevalence of obstructive sleep apnea (OSA) among patients h... more We determined sex differences in the prevalence of obstructive sleep apnea (OSA) among patients hospitalized with pulmonary embolism (PE) in Spain (2016–2018). We also compared outcomes according to the presence of OSA, and identified variables associated with in-hospital-mortality (IHM) after PE using the Spanish National Hospital Discharge Database. We identified 46,794 hospital admissions for PE; of these, 5.47% had OSA. OSA was more prevalent among men than women (7.57% vs. 3.65%, p < 0.001), as in the general population. Propensity score matching did not reveal differences in concomitant conditions or procedures between patients with and without OSA, except for the use of non-invasive ventilation, which was more frequent in patients with OSA. IHM was similar in patients with and without OSA (3.58% vs. 4.31% for men and 4.39% vs. 4.93% for women; p > 0.05). Older age, cancer, atrial fibrillation, non-septic shock, and need for mechanical ventilation increased IHM in men an...

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Research paper thumbnail of Validation of a prognostic score for hidden cancer in unprovoked venous thromboembolism

PloS one, 2018

The usefulness of a diagnostic workup for occult cancer in patients with venous thromboembolism (... more The usefulness of a diagnostic workup for occult cancer in patients with venous thromboembolism (VTE) is controversial. We used the RIETE (Registro Informatizado Enfermedad Trombo Embólica) database to perform a nested case-control study to validate a prognostic score that identifies patients with unprovoked VTE at increased risk for cancer. We dichotomized patients as having low- (≤2 points) or high (≥3 points) risk for cancer, and tried to validate the score at 12 and 24 months. From January 2014 to October 2016, 11,695 VTE patients were recruited. Of these, 1,360 with unprovoked VTE (11.6%) were eligible for the study. At 12 months, 52 patients (3.8%; 95%CI: 2.9-5%) were diagnosed with cancer. Among 905 patients (67%) scoring ≤2 points, 22 (2.4%) had cancer. Among 455 scoring ≥3 points, 30 (6.6%) had cancer (hazard ratio 2.8; 95%CI 1.6-5; p<0.01). C-statistic was 0.63 (95%CI 0.55-0.71). At 24 months, 58 patients (4.3%; 95%CI: 3.3-5.5%) were diagnosed with cancer. Among 905 pat...

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Research paper thumbnail of Design and rationale of the non-interventional, edoxaban treatment in routiNe clinical prActice in patients with venous ThromboEmbolism in Europe (ETNA-VTE-Europe) study

Thrombosis journal, 2018

Venous thromboembolism (VTE, including deep vein thrombosis [DVT] and pulmonary embolism [PE]) ha... more Venous thromboembolism (VTE, including deep vein thrombosis [DVT] and pulmonary embolism [PE]) has an annual incidence rate of 104-183 per 100,000 person-years. After a VTE episode, the two-year recurrence rate is about 17%. Consequently, effective and safe anticoagulation is paramount. Edoxaban is a direct oral anticoagulant (DOAC) approved VTE treatment. Current safety and efficacy data are derived from clinical trials, and information about treatment durations beyond 12 months are not available. ETNA-VTE-Europe is an 18-month prospective, single-arm, non-interventional, multinational post-authorisation safety study. Approximately 310 sites across eight European countries (Austria, Belgium, Germany, Ireland, Italy, the Netherlands, Switzerland and the United Kingdom) will participate in the study, with the intention to represent the regional distributions of centres, healthcare settings and specialties. An estimated cohort of 2700 patients will be recruited, the only enrolment cri...

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Research paper thumbnail of Dynamics of case-fatalilty rates of recurrent thromboembolism and major bleeding in patients treated for venous thromboembolism

Thrombosis and haemostasis, 2013

In patients with venous thromboembolism (VTE), assessment of the risk of fatal recurrent VTE and ... more In patients with venous thromboembolism (VTE), assessment of the risk of fatal recurrent VTE and fatal bleeding during anticoagulation may help to guide intensity and duration of therapy. We aimed to provide estimates of the case-fatality rate (CFR) of recurrent VTE and major bleeding during anticoagulation in a 'real life' population, and to assess these outcomes according to the initial presentation of VTE and its etiology. The study included 41,826 patients with confirmed VTE from the RIETE registry who received different durations of anticoagulation (mean 7.8 ± 0.6 months). During 27,110 patient-years, the CFR was 12.1% (95% CI, 10.2-14.2) for recurrent VTE, and 19.7% (95% CI, 17.4-22.1) for major bleeding. During the first three months of anticoagulant therapy, the CFR of recurrent VTE was 16.1% (95% CI, 13.6-18.9), compared to 2.0% (95% CI, 0-4.2) beyond this period. The CFR of bleeding was 20.2% (95% CI, 17.5-23.1) during the first three months, compared to 18.2% (95%...

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Research paper thumbnail of Reply: Immortal time bias and the use of IVC filters

Journal of the American College of Cardiology, Jan 2, 2014

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Research paper thumbnail of Rivaroxaban in the Treatment of Venous Thromboembolism and the Prevention of Recurrences: A Practical Approach

Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis, Jan 9, 2014

Anticoagulation therapy is the standard treatment of patients with symptomatic venous thromboembo... more Anticoagulation therapy is the standard treatment of patients with symptomatic venous thromboembolism (VTE), including deep vein thrombosis and pulmonary embolism. Until recently, treatment of VTE was based on parenteral or low-molecular-weight heparin for initial therapy (5-10 days) and oral vitamin K antagonists for long-term therapy. Those treatments have some limitations, including parenteral administration (heparins), the need for frequent monitoring and dose adjustments, interactions with several medications, and dietary restrictions (vitamin K antagonists). Rivaroxaban is a new oral direct factor Xa inhibitor with a wide therapeutic window, predictable anticoagulant effect, no food interactions, and few drug interactions. Consequently, no periodic monitoring of anticoagulation is needed, and fixed doses can be prescribed. EINSTEIN program demonstrated that rivaroxaban was as effective as and significantly safer than standard therapy for treatment of VTE. Rivaroxaban was recen...

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Research paper thumbnail of Age-adjusted hsTnT cut-off value for risk stratification of pulmonary embolism

The European respiratory journal, Jan 22, 2015

High-sensitivity troponin T (hsTnT) helps in identifying pulmonary embolism patients at low risk ... more High-sensitivity troponin T (hsTnT) helps in identifying pulmonary embolism patients at low risk of an adverse outcome. In 682 normotensive pulmonary embolism patients we investigate whether an optimised hsTnT cut-off value and adjustment for age improve the identification of patients at elevated risk. Overall, 25 (3.7%) patients had an adverse 30-day outcome. The established hsTnT cut-off value of 14 pg·mL(-1) retained its high prognostic value (OR (95% CI) 16.64 (2.24-123.74); p=0.006) compared with the cut-off value of 33 pg·mL(-1) calculated by receiver operating characteristic analysis (7.14 (2.64-19.26); p<0.001). In elderly (aged ⩾75 years) patients, an age-optimised hsTnT cut-off value of 45 pg·mL(-1) but not the established cut-off value of 14 pg·mL(-1) predicted an adverse outcome. An age-adjusted hsTnT cut-off value (⩾14 pg·mL(-1) for patients aged <75 years and ⩾45 pg·mL(-1) for patients aged ⩾75 years) provided additive and independent prognostic information on to...

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Research paper thumbnail of Short-term clinical outcome of normotensive patients with acute PE and high plasma lactate

Thorax, Jan 6, 2015

Strategies for identifying normotensive patients with acute symptomatic PE at high risk of PE-rel... more Strategies for identifying normotensive patients with acute symptomatic PE at high risk of PE-related complications remain to be defined. This prospective cohort study aimed to determine the role of plasma lactate levels in the risk assessment of normotensive patients with acute PE. Outcomes assessed over the 7 days after the diagnosis of PE included PE-related mortality and haemodynamic collapse, defined as need for cardiopulmonary resuscitation, systolic blood pressure <90 mm Hg for at least 15 min, need for catecholamine administration, or need for mechanical ventilation. Between December 2012 and January 2014, the study enrolled 496 normotensive outpatients with acute symptomatic PE. PE-related complications occurred in 20 (4.0%; 95% CI 2.5% to 6.2%) of the 496 patients. These patients had higher baseline lactate levels (median 2.66 mmol/L; IQR 1.56-5.96 mmol/L) than patients without complications (1.20 mmol/L; IQR 1.20-2.00 mmol/L) (p<0.001). Overall, 135 patients (27.2%)...

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Research paper thumbnail of Computerised clinical decision support for suspected PE: Table 1

Thorax, 2015

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Research paper thumbnail of Anti-factor Xa Activity of Enoxaparin for Thromboprophylaxis in Nonsurgical Patients Is Dependent on Body Mass

Archivos de Bronconeumología ((English Edition)), 2008

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Research paper thumbnail of Thromboembolic Events in Patients After a Negative Computed Tomography Pulmonary Angiogram: a Retrospective Study of 165 Patients

Archivos de Bronconeumología ((English Edition)), 2006

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Research paper thumbnail of Outcome of incidentally diagnosed pulmonary embolism in patients with malignancy

Current Opinion in Pulmonary Medicine, 2012

Bookmarks Related papers MentionsView impact

Research paper thumbnail of Modelli prognostici finalizzati alla selezione di pazienti con embolia polmonare acuta per il trattamento iniziale non ospedaliero

For specialists in

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Research paper thumbnail of Combinations of prognostic tools for identification of high-risk normotensive patients with acute symptomatic pulmonary embolism

Thorax, 2010

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Research paper thumbnail of Prognostic significance of multidetector CT in normotensive patients with pulmonary embolism: results of the protect study

Thorax, 2013

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Research paper thumbnail of Pulmonary embolism at home

European Respiratory Journal, 2008

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Research paper thumbnail of Changes in PESI scores predict mortality in intermediate-risk patients with acute pulmonary embolism

European Respiratory Journal, 2012

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Research paper thumbnail of Weekend Versus Weekday Admission and Mortality After Acute Pulmonary Embolism

Circulation, 2009

Background— Optimal management of acute pulmonary embolism (PE) requires medical expertise, diagn... more Background— Optimal management of acute pulmonary embolism (PE) requires medical expertise, diagnostic testing, and therapies that may not be available consistently throughout the entire week. We sought to assess whether associations exist between weekday or weekend admission and mortality and length of hospital stay for patients hospitalized with PE. Methods and Results— We evaluated patients discharged with a primary diagnosis of PE from 186 acute care hospitals in Pennsylvania (January 2000 to November 2002). We used random-effect logistic models to study the association between weekend admission and 30-day mortality and used discrete survival models to study the association between weekend admission and time to hospital discharge, adjusting for hospital (region, size, and teaching status) and patient factors (race, insurance, severity of illness, and use of thrombolytic therapy). Among 15 531 patient discharges with PE, 3286 patients (21.2%) had been admitted on a weekend. Patie...

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Research paper thumbnail of Profilaxis de la enfermedad tromboembólica venosa

Archivos de Bronconeumología, 2008

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Research paper thumbnail of Enfermedad pulmonar obstructiva crónica en pacientes con tromboembolia de pulmón aguda sintomática

Archivos de Bronconeumología, 2009

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Research paper thumbnail of Sex-differences in the effect of obstructive sleep apnea on patients hospitalized with pulmonary embolism and on in-hospital mortality

Scientific Reports, 2021

We determined sex differences in the prevalence of obstructive sleep apnea (OSA) among patients h... more We determined sex differences in the prevalence of obstructive sleep apnea (OSA) among patients hospitalized with pulmonary embolism (PE) in Spain (2016–2018). We also compared outcomes according to the presence of OSA, and identified variables associated with in-hospital-mortality (IHM) after PE using the Spanish National Hospital Discharge Database. We identified 46,794 hospital admissions for PE; of these, 5.47% had OSA. OSA was more prevalent among men than women (7.57% vs. 3.65%, p < 0.001), as in the general population. Propensity score matching did not reveal differences in concomitant conditions or procedures between patients with and without OSA, except for the use of non-invasive ventilation, which was more frequent in patients with OSA. IHM was similar in patients with and without OSA (3.58% vs. 4.31% for men and 4.39% vs. 4.93% for women; p > 0.05). Older age, cancer, atrial fibrillation, non-septic shock, and need for mechanical ventilation increased IHM in men an...

Bookmarks Related papers MentionsView impact

Research paper thumbnail of Validation of a prognostic score for hidden cancer in unprovoked venous thromboembolism

PloS one, 2018

The usefulness of a diagnostic workup for occult cancer in patients with venous thromboembolism (... more The usefulness of a diagnostic workup for occult cancer in patients with venous thromboembolism (VTE) is controversial. We used the RIETE (Registro Informatizado Enfermedad Trombo Embólica) database to perform a nested case-control study to validate a prognostic score that identifies patients with unprovoked VTE at increased risk for cancer. We dichotomized patients as having low- (≤2 points) or high (≥3 points) risk for cancer, and tried to validate the score at 12 and 24 months. From January 2014 to October 2016, 11,695 VTE patients were recruited. Of these, 1,360 with unprovoked VTE (11.6%) were eligible for the study. At 12 months, 52 patients (3.8%; 95%CI: 2.9-5%) were diagnosed with cancer. Among 905 patients (67%) scoring ≤2 points, 22 (2.4%) had cancer. Among 455 scoring ≥3 points, 30 (6.6%) had cancer (hazard ratio 2.8; 95%CI 1.6-5; p<0.01). C-statistic was 0.63 (95%CI 0.55-0.71). At 24 months, 58 patients (4.3%; 95%CI: 3.3-5.5%) were diagnosed with cancer. Among 905 pat...

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Research paper thumbnail of Design and rationale of the non-interventional, edoxaban treatment in routiNe clinical prActice in patients with venous ThromboEmbolism in Europe (ETNA-VTE-Europe) study

Thrombosis journal, 2018

Venous thromboembolism (VTE, including deep vein thrombosis [DVT] and pulmonary embolism [PE]) ha... more Venous thromboembolism (VTE, including deep vein thrombosis [DVT] and pulmonary embolism [PE]) has an annual incidence rate of 104-183 per 100,000 person-years. After a VTE episode, the two-year recurrence rate is about 17%. Consequently, effective and safe anticoagulation is paramount. Edoxaban is a direct oral anticoagulant (DOAC) approved VTE treatment. Current safety and efficacy data are derived from clinical trials, and information about treatment durations beyond 12 months are not available. ETNA-VTE-Europe is an 18-month prospective, single-arm, non-interventional, multinational post-authorisation safety study. Approximately 310 sites across eight European countries (Austria, Belgium, Germany, Ireland, Italy, the Netherlands, Switzerland and the United Kingdom) will participate in the study, with the intention to represent the regional distributions of centres, healthcare settings and specialties. An estimated cohort of 2700 patients will be recruited, the only enrolment cri...

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Research paper thumbnail of Dynamics of case-fatalilty rates of recurrent thromboembolism and major bleeding in patients treated for venous thromboembolism

Thrombosis and haemostasis, 2013

In patients with venous thromboembolism (VTE), assessment of the risk of fatal recurrent VTE and ... more In patients with venous thromboembolism (VTE), assessment of the risk of fatal recurrent VTE and fatal bleeding during anticoagulation may help to guide intensity and duration of therapy. We aimed to provide estimates of the case-fatality rate (CFR) of recurrent VTE and major bleeding during anticoagulation in a 'real life' population, and to assess these outcomes according to the initial presentation of VTE and its etiology. The study included 41,826 patients with confirmed VTE from the RIETE registry who received different durations of anticoagulation (mean 7.8 ± 0.6 months). During 27,110 patient-years, the CFR was 12.1% (95% CI, 10.2-14.2) for recurrent VTE, and 19.7% (95% CI, 17.4-22.1) for major bleeding. During the first three months of anticoagulant therapy, the CFR of recurrent VTE was 16.1% (95% CI, 13.6-18.9), compared to 2.0% (95% CI, 0-4.2) beyond this period. The CFR of bleeding was 20.2% (95% CI, 17.5-23.1) during the first three months, compared to 18.2% (95%...

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Research paper thumbnail of Reply: Immortal time bias and the use of IVC filters

Journal of the American College of Cardiology, Jan 2, 2014

Bookmarks Related papers MentionsView impact

Research paper thumbnail of Rivaroxaban in the Treatment of Venous Thromboembolism and the Prevention of Recurrences: A Practical Approach

Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis, Jan 9, 2014

Anticoagulation therapy is the standard treatment of patients with symptomatic venous thromboembo... more Anticoagulation therapy is the standard treatment of patients with symptomatic venous thromboembolism (VTE), including deep vein thrombosis and pulmonary embolism. Until recently, treatment of VTE was based on parenteral or low-molecular-weight heparin for initial therapy (5-10 days) and oral vitamin K antagonists for long-term therapy. Those treatments have some limitations, including parenteral administration (heparins), the need for frequent monitoring and dose adjustments, interactions with several medications, and dietary restrictions (vitamin K antagonists). Rivaroxaban is a new oral direct factor Xa inhibitor with a wide therapeutic window, predictable anticoagulant effect, no food interactions, and few drug interactions. Consequently, no periodic monitoring of anticoagulation is needed, and fixed doses can be prescribed. EINSTEIN program demonstrated that rivaroxaban was as effective as and significantly safer than standard therapy for treatment of VTE. Rivaroxaban was recen...

Bookmarks Related papers MentionsView impact

Research paper thumbnail of Age-adjusted hsTnT cut-off value for risk stratification of pulmonary embolism

The European respiratory journal, Jan 22, 2015

High-sensitivity troponin T (hsTnT) helps in identifying pulmonary embolism patients at low risk ... more High-sensitivity troponin T (hsTnT) helps in identifying pulmonary embolism patients at low risk of an adverse outcome. In 682 normotensive pulmonary embolism patients we investigate whether an optimised hsTnT cut-off value and adjustment for age improve the identification of patients at elevated risk. Overall, 25 (3.7%) patients had an adverse 30-day outcome. The established hsTnT cut-off value of 14 pg·mL(-1) retained its high prognostic value (OR (95% CI) 16.64 (2.24-123.74); p=0.006) compared with the cut-off value of 33 pg·mL(-1) calculated by receiver operating characteristic analysis (7.14 (2.64-19.26); p<0.001). In elderly (aged ⩾75 years) patients, an age-optimised hsTnT cut-off value of 45 pg·mL(-1) but not the established cut-off value of 14 pg·mL(-1) predicted an adverse outcome. An age-adjusted hsTnT cut-off value (⩾14 pg·mL(-1) for patients aged <75 years and ⩾45 pg·mL(-1) for patients aged ⩾75 years) provided additive and independent prognostic information on to...

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Research paper thumbnail of Short-term clinical outcome of normotensive patients with acute PE and high plasma lactate

Thorax, Jan 6, 2015

Strategies for identifying normotensive patients with acute symptomatic PE at high risk of PE-rel... more Strategies for identifying normotensive patients with acute symptomatic PE at high risk of PE-related complications remain to be defined. This prospective cohort study aimed to determine the role of plasma lactate levels in the risk assessment of normotensive patients with acute PE. Outcomes assessed over the 7 days after the diagnosis of PE included PE-related mortality and haemodynamic collapse, defined as need for cardiopulmonary resuscitation, systolic blood pressure <90 mm Hg for at least 15 min, need for catecholamine administration, or need for mechanical ventilation. Between December 2012 and January 2014, the study enrolled 496 normotensive outpatients with acute symptomatic PE. PE-related complications occurred in 20 (4.0%; 95% CI 2.5% to 6.2%) of the 496 patients. These patients had higher baseline lactate levels (median 2.66 mmol/L; IQR 1.56-5.96 mmol/L) than patients without complications (1.20 mmol/L; IQR 1.20-2.00 mmol/L) (p<0.001). Overall, 135 patients (27.2%)...

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Research paper thumbnail of Computerised clinical decision support for suspected PE: Table 1

Thorax, 2015

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Research paper thumbnail of Anti-factor Xa Activity of Enoxaparin for Thromboprophylaxis in Nonsurgical Patients Is Dependent on Body Mass

Archivos de Bronconeumología ((English Edition)), 2008

Bookmarks Related papers MentionsView impact

Research paper thumbnail of Thromboembolic Events in Patients After a Negative Computed Tomography Pulmonary Angiogram: a Retrospective Study of 165 Patients

Archivos de Bronconeumología ((English Edition)), 2006

Bookmarks Related papers MentionsView impact

Research paper thumbnail of Outcome of incidentally diagnosed pulmonary embolism in patients with malignancy

Current Opinion in Pulmonary Medicine, 2012

Bookmarks Related papers MentionsView impact

Research paper thumbnail of Modelli prognostici finalizzati alla selezione di pazienti con embolia polmonare acuta per il trattamento iniziale non ospedaliero

For specialists in

Bookmarks Related papers MentionsView impact

Research paper thumbnail of Combinations of prognostic tools for identification of high-risk normotensive patients with acute symptomatic pulmonary embolism

Thorax, 2010

Bookmarks Related papers MentionsView impact

Research paper thumbnail of Prognostic significance of multidetector CT in normotensive patients with pulmonary embolism: results of the protect study

Thorax, 2013

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Research paper thumbnail of Pulmonary embolism at home

European Respiratory Journal, 2008

Bookmarks Related papers MentionsView impact

Research paper thumbnail of Changes in PESI scores predict mortality in intermediate-risk patients with acute pulmonary embolism

European Respiratory Journal, 2012

Bookmarks Related papers MentionsView impact

Research paper thumbnail of Weekend Versus Weekday Admission and Mortality After Acute Pulmonary Embolism

Circulation, 2009

Background— Optimal management of acute pulmonary embolism (PE) requires medical expertise, diagn... more Background— Optimal management of acute pulmonary embolism (PE) requires medical expertise, diagnostic testing, and therapies that may not be available consistently throughout the entire week. We sought to assess whether associations exist between weekday or weekend admission and mortality and length of hospital stay for patients hospitalized with PE. Methods and Results— We evaluated patients discharged with a primary diagnosis of PE from 186 acute care hospitals in Pennsylvania (January 2000 to November 2002). We used random-effect logistic models to study the association between weekend admission and 30-day mortality and used discrete survival models to study the association between weekend admission and time to hospital discharge, adjusting for hospital (region, size, and teaching status) and patient factors (race, insurance, severity of illness, and use of thrombolytic therapy). Among 15 531 patient discharges with PE, 3286 patients (21.2%) had been admitted on a weekend. Patie...

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Research paper thumbnail of Profilaxis de la enfermedad tromboembólica venosa

Archivos de Bronconeumología, 2008

Bookmarks Related papers MentionsView impact

Research paper thumbnail of Enfermedad pulmonar obstructiva crónica en pacientes con tromboembolia de pulmón aguda sintomática

Archivos de Bronconeumología, 2009

Bookmarks Related papers MentionsView impact