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Medline ® Abstract for Reference 16

of '成人癌症患者静脉血栓栓塞症的风险及预防'

16
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Frequency, risk factors, and trends for venous thromboembolism among hospitalized cancer patients.
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Khorana AA, Francis CW, Culakova E, Kuderer NM, Lyman GH
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Cancer. 2007;110(10):2339.
 
BACKGROUND: Venous thromboembolism (VTE) contributes to morbidity and mortality in cancer patients and is a frequent complication of anticancer therapy. In the current study, the frequency, risk factors, and trends associated with VTE were examined among hospitalized cancer patients.
METHODS: A retrospective cohort study was conducted using the discharge database of the University HealthSystem Consortium. This included 1,824,316 hospitalizations between 1995 and 2003 at 133 U.S. medical centers.
RESULTS: Among 1,015,598 cancer patients, 34,357 (3.4%) were diagnosed with deep venous thrombosis and 11,515 with pulmonary embolism (PE) (1.1%) for an overall VTE rate of 4.1%. Subgroups of cancer patients with the highest rates included black ethnicity (5.1% per hospitalization) and those receiving chemotherapy (4.9%). Sites of cancer with the highest rates of VTE included pancreas (8.1%), kidney (5.6%), ovary (5.6%), lung (5.1%), and stomach (4.9%). Among hematologic malignancies, myeloma (5%), non-Hodgkin lymphoma (4.8%), and Hodgkin disease (4.6%) had the highest rates ofVTE. The rate of VTE increased by 28%, secondary to a near-doubling of PE rates from 0.8% to 1.5% (P<.0001). Among patients receiving chemotherapy, the rates of VTE rose from 3.9% to 5.7%, an increase of 47% (P<.0001). In multivariate analysis, risk factors associated with VTE included age>or=65 years, female sex, black ethnicity, use of chemotherapy, primary site of cancer, presence of comorbidities, and year of admission.
CONCLUSIONS: VTE, particularly PE, is an increasingly frequent complication of hospitalization in cancer patients. Patients with black ethnicity, specific sites of cancer, or those receiving chemotherapy are disproportionately at risk.
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James P. Wilmot Cancer Center and the Department of Medicine, University of Rochester, Rochester, New York 14642, USA. alok_khorana@URMC.rochester.edu
PMID